Department of Orthopaedic Surgery, Southern California Permanente Medical Group, Los Angeles, California.
Surgical Outcomes and Analysis, Kaiser Permanente, San Diego, California.
J Arthroplasty. 2014 Aug;29(8):1635-8. doi: 10.1016/j.arth.2014.03.014. Epub 2014 Mar 21.
As the nonagenarian patient population continues to grow, more patients aged 90 and over will become candidates for total knee arthroplasty (TKA). This study evaluated the patient characteristics and incidence of postoperative morbidity and mortality of 216 nonagenarian TKA patients among 81,835 primary TKA patients followed by a total joint replacement registry. Nonagenarians had a greater number of comorbidities preoperatively, experienced a higher rate of deep vein thrombosis and 30 day mortality, and had a longer hospital length of stay. However, nonagenarians did not have an increased risk of infection nor pulmonary embolism and postoperative mortality was within expected rates for individuals 90 years and older. Higher readmission rates, however, highlight the benefits of close follow up during a prolonged postoperative period.
随着 90 岁以上老年患者人群的不断增加，越来越多的 90 岁及以上患者将成为全膝关节置换术（TKA）的候选者。本研究评估了在一个关节置换登记处随访的 81835 例初次 TKA 患者中，216 例 90 岁以上 TKA 患者的患者特征以及术后发病率和死亡率。90 岁以上患者术前合并症更多，深静脉血栓形成和 30 天死亡率更高，住院时间更长。然而，90 岁以上患者发生感染或肺栓塞的风险并未增加，术后死亡率处于 90 岁及以上人群的预期范围内。然而，更高的再入院率突出表明，在延长的术后期间需要密切随访。
