Chen Chi-Lung, Shao Hongyi, Block Jessica L, Chen Antonia F
Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania; Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan.
Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
J Arthroplasty. 2016 Jul;31(7):1431-6. doi: 10.1016/j.arth.2015.12.046. Epub 2016 Feb 26.
Little is known about total joint arthroplasty (TJA) outcomes in gout patients. The purpose of this study was to compare adverse events between gout and nongout patients who underwent primary TJA.
Using our institutional database and medical records review, a retrospective case-control study was conducted. From 2000 to 2012, a total of 482 gout TJA patients were matched with nongout TJA patients in a 1:1 ratio. Length of stay, complications, 90-day emergency room visits, and 90-day readmissions in these patients were compared.
Gout patients had greater wound healing problems (12.2% vs 5.0%, P = .001) and renal complications (8.9% vs 3.1%, P = .0003) compared with nongout patients. There were no significant differences between gout and nongout patients in terms of mean length of hospital stay (3.82 vs 3.17 days, P = .11) and 90-day emergency room visits (5.6% vs 3.5%, P = 1.00). Subgroup analysis showed that 90-day readmission rates were higher in gout patients who underwent total hip arthroplasty compared with those in nongout THA patients (6.8% vs 2.1%, P = .02).
Gout patients undergoing TJA have greater wound healing problems and renal complications. Surgeons should be cognizant of fluid management, renal monitoring and wound issues and should be cautious when treating TJA gout patients.
痛风患者全关节置换术(TJA)的结果鲜为人知。本研究的目的是比较接受初次TJA的痛风患者和非痛风患者的不良事件。
通过我们的机构数据库和病历回顾,进行了一项回顾性病例对照研究。从2000年到2012年,共482例痛风TJA患者与非痛风TJA患者按1:1比例匹配。比较了这些患者的住院时间、并发症、90天急诊就诊次数和90天再入院率。
与非痛风患者相比,痛风患者有更多的伤口愈合问题(12.2%对5.0%,P = .001)和肾脏并发症(8.9%对3.1%,P = .0003)。痛风患者和非痛风患者在平均住院时间(3.82天对3.17天,P = .11)和90天急诊就诊次数(5.6%对3.5%,P = 1.00)方面没有显著差异。亚组分析显示,接受全髋关节置换术的痛风患者的90天再入院率高于非痛风全髋关节置换术患者(6.8%对2.1%,P = .02)。
接受TJA的痛风患者有更多的伤口愈合问题和肾脏并发症。外科医生应注意液体管理、肾脏监测和伤口问题,在治疗TJA痛风患者时应谨慎。