Elings J, Hoogeboom T J, van der Sluis G, van Meeteren N L U
Department of Physical Therapy, Diakonessenhuis Hospital, Utrecht, the Netherlands Department of Epidemiology, Maastricht University Medical Centre, the Netherlands
Department of Epidemiology, Maastricht University Medical Centre, the Netherlands Centre for Care Technology Research (CCTR), Maastricht, the Netherlands.
Clin Rehabil. 2015 May;29(5):477-92. doi: 10.1177/0269215514545349. Epub 2014 Oct 15.
To identify the preoperative patient-related characteristics predicting inpatient recovery of functioning and/or length of hospital stay after elective primary total hip arthroplasty.
A search was conducted of the electronic databases MEDLINE, EMBASE and CINAHL from inception through April 2014. Observational studies were selected for systematic review if they identified clinically relevant preoperative prognostic factors and reported an association between inpatient recovery of physical functioning and/or length of hospital stay. Study participants were adults undergoing an elective primary total hip arthroplasty.
Fourteen studies were included, a total of 199,410 individual total hip arthroplasty procedures. Two studies investigated inpatient recovery of physical functioning, no strong level of evidence was found for a relationship between functional recovery and any of the preoperative predictors. Twelve studies investigated the length of hospital stay and reported 19 preoperative prognostic factors. A strong level of evidence suggested that higher scores on the American Society of Anaesthesiologists assessment (OR 3.34 to 6.22, +0.20 days), increased number of comorbidities (RR of 1.10, +0.59 to 1.61 days), presence of heart disease, (RR of 1.59, +0.26 days), and presence of lung disease (RR of 1.30, +0.34 days) were associated with longer lengths of hospital stay following total hip arthroplasty.
For the prediction of inpatient recovery of physical functioning no factors with a strong level of evidence were found. For length of stay there was a strong level of evidence for the American Society of Anaesthesiologists score, number of comorbidities, and presence of heart or lung disease.
确定择期初次全髋关节置换术后预测患者住院功能恢复和/或住院时间的术前相关特征。
检索了电子数据库MEDLINE、EMBASE和CINAHL，检索时间从建库至2014年4月。如果观察性研究确定了临床相关的术前预后因素，并报告了住院期间身体功能恢复与住院时间之间的关联，则选择这些研究进行系统评价。研究参与者为接受择期初次全髋关节置换术的成年人。
纳入14项研究，共199410例全髋关节置换手术。两项研究调查了住院期间的身体功能恢复情况，未发现功能恢复与任何术前预测因素之间存在强有力的证据关系。12项研究调查了住院时间，并报告了19个术前预后因素。强有力的证据表明，美国麻醉医师协会评估得分较高（比值比3.34至6.22，住院时间增加0.20天）、合并症数量增加（风险比1.10，住院时间增加0.59至1.61天）、存在心脏病（风险比1.59，住院时间增加0.26天）和存在肺病（风险比1.30，住院时间增加0.34天）与全髋关节置换术后住院时间延长相关。
对于预测住院期间身体功能恢复情况，未发现有强有力证据支持的因素。对于住院时间，美国麻醉医师协会评分、合并症数量以及存在心脏或肺部疾病有强有力的证据支持。
