Alazzawi S, Bardakos N V, Hadfield S G, Butt U, Beer Z H, Field R E
University College Hospital, 235 Euston Road, London NW1 2BU, UK.
J Bone Joint Surg Br. 2012 Aug;94(8):1120-5. doi: 10.1302/0301-620X.94B8.29040.
Using general practitioner records and hospital notes and through direct telephone conversation with patients, we investigated the accuracy of nine patient-reported complications gathered from a self-completed questionnaire after elective joint replacement surgery of the hip and knee. A total of 402 post-discharge complications were reported after 8546 elective operations that were undertaken within a three-year period. These were reported by 136 men and 240 women with a mean age of 71.8 years (34 to 93). A total of 319 reported complications (79.4%; 95% confidence interval 75.4 to 83.3) were confirmed to be correct. High rates of correct reporting were demonstrated for infection (94.5%) and the need for further surgery (100%), whereas the rates of reporting deep-vein thrombosis (DVT), pulmonary embolism, myocardial infarction and stroke were lower (75% to 84.2%). Dislocation, peri-prosthetic fractures and nerve palsy had modest rates of correct reporting (36% to 57.1%). More patients who had knee surgery delivered incorrect reports of dislocation (p = 0.001) and DVT (p = 0.013). Despite these variations, it appears that post-operative complications may form part of a larger patient-reported outcome programme after elective joint replacement surgery.
我们利用全科医生记录、医院病历，并通过与患者直接电话沟通，调查了髋关节和膝关节择期置换手术后通过自我填写问卷收集的9种患者报告并发症的准确性。在三年期间进行的8546例择期手术之后，共报告了402例出院后并发症。这些并发症由136名男性和240名女性报告，平均年龄为71.8岁（34至93岁）。共319例报告的并发症（79.4%；95%置信区间75.4至83.3）被证实是正确的。感染（94.5%）和再次手术需求（100%）的正确报告率较高，而深静脉血栓形成（DVT）、肺栓塞、心肌梗死和中风的报告率较低（75%至84.2%）。脱位、假体周围骨折和神经麻痹的正确报告率适中（36%至57.1%）。更多接受膝关节手术的患者对脱位（p = 0.001）和DVT（p = 0.013）的报告有误。尽管存在这些差异，但似乎术后并发症可能是择期关节置换手术后更大的患者报告结局计划的一部分。
