吸烟与全髋关节置换术后假体相关并发症的风险：队列研究的荟萃分析

Smoking and risk of prosthesis-related complications after total hip arthroplasty: a meta-analysis of cohort studies.

作者信息

Teng Songsong, Yi Chengqing, Krettek Christian, Jagodzinski Michael

机构信息

Department of Orthopedic Trauma, Hannover Medical School, Hanover, Germany; Department of Orthopedics, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, P. R. China.

Department of Orthopedics, Shanghai First People's Hospital, Shanghai Jiao Tong University, Shanghai, P. R. China.

出版信息

PLoS One. 2015 Apr 24;10(4):e0125294. doi: 10.1371/journal.pone.0125294. eCollection 2015.

OBJECTIVE

Increasing evidence suggests that smoking may increase the incidence of prosthesis-related complications after total hip arthroplasty (THA). We performed a meta-analysis of cohort studies to quantitatively evaluate the association between smoking and the risk of prosthesis-related complications after THA.

METHODS

Relevant articles published before August 15, 2014, were identified by searching the PubMed, EMBASE and Cochrane library databases. Pooled risk ratios (RRs) or weighted mean differences (WMDs) with 95% confidence intervals (CIs) were calculated with either a fixed- or random-effects model.

RESULTS

Six cohort studies, involving a total of 8181 participants, were included in the meta-analysis. Compared with the patients who never smoked, smokers had a significantly increased risk of aseptic loosening of prosthesis (summary RR=3.05, 95% CI: 1.42-6.58), deep infection (summary RR=3.71, 95% CI: 1.86-7.41) and all-cause revisions (summary RR=2.58, 95% CI: 1.27-5.22). However, no significant difference in the risk of implant dislocation (summary RR= 1.27, 95% CI: 0.77-2.10) or length of hospital stay (WMD=0.03, 95% CI: -0.65-0.72) was found between smokers and nonsmokers.

CONCLUSIONS

Smoking is associated with a significantly increased risk of aseptic loosening of prosthesis, deep infection and all-cause revisions after THA, but smoking is not correlated with a risk of implant dislocation or the length of hospital stay after surgery.

目的

越来越多的证据表明，吸烟可能会增加全髋关节置换术（THA）后假体相关并发症的发生率。我们进行了一项队列研究的荟萃分析，以定量评估吸烟与THA后假体相关并发症风险之间的关联。

方法

通过检索PubMed、EMBASE和Cochrane图书馆数据库，确定2014年8月15日前发表的相关文章。采用固定效应模型或随机效应模型计算合并风险比（RRs）或加权平均差（WMDs）及95%置信区间（CIs）。

结果

六项队列研究共纳入8181名参与者，纳入荟萃分析。与从不吸烟的患者相比，吸烟者发生假体无菌性松动（汇总RR=3.05，95%CI：1.42-6.58）、深部感染（汇总RR=3.71，95%CI：1.86-7.41）和全因翻修（汇总RR=2.58，95%CI：1.27-5.22）的风险显著增加。然而，吸烟者和非吸烟者在植入物脱位风险（汇总RR=1.27，95%CI：0.77-2.10）或住院时间（WMD=0.03，95%CI：-0.65-0.72）方面未发现显著差异。