Amlie Einar, Lerdal Anners, Gay Caryl L, Høvik Øystein, Nordsletten Lars, Dimmen Sigbjørn
Orthopedic Research Group, Lovisenberg Diakonale Hospital, Nydalen, P.O. Box 4970, 0440 Oslo, Norway.
Orthopedic Research Group, Lovisenberg Diakonale Hospital, Nydalen, P.O. Box 4970, 0440 Oslo, Norway; Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Blindern, P.O. Box 1130, 0450 Oslo, Norway.
Adv Orthop. 2016;2016:7901953. doi: 10.1155/2016/7901953. Epub 2016 Feb 29.
Rates of revision surgery due to deep infection following total hip arthroplasty (THA) increased at a Norwegian hospital following implementation of fast-track procedures. The purpose of this study was to determine whether selected demographic (age and sex) and clinical (body mass index, American Society of Anesthesiologists (ASA) classification, surgery duration, length of hospital stay, cemented versus uncemented prosthesis, and fast-track procedures) factors were associated with higher risk of revision surgery due to deep infection following THA. In a prospective designed study 4,406 patients undergoing primary THA between January 2001 and January 2013 where included. Rates of infection-related revision surgery within 3 months of THA were higher among males and among patients who received fast-track THA. Adjusting for sex and age, the implemented fast-track elements were significantly associated with increased risk of revision surgery. Risk of infection-related revision surgery was unrelated to body mass index, physical status, surgery duration, length of hospital stay, and prosthesis type. Because local infiltration analgesia, drain cessation, and early mobilization were introduced in combination, it could not be determined which component or combination of components imposed the increased risk. The findings in this small sample raise concern about fast-track THA but require replication in other samples.
在一家挪威医院实施快速康复程序后，全髋关节置换术（THA）后因深部感染而进行翻修手术的比率有所增加。本研究的目的是确定选定的人口统计学因素（年龄和性别）和临床因素（体重指数、美国麻醉医师协会（ASA）分级、手术时长、住院时间、骨水泥型与非骨水泥型假体以及快速康复程序）是否与THA后因深部感染而进行翻修手术的较高风险相关。在一项前瞻性设计研究中，纳入了2001年1月至2013年1月期间接受初次THA的4406例患者。THA后3个月内与感染相关的翻修手术发生率在男性以及接受快速康复THA的患者中较高。在对性别和年龄进行校正后，所实施的快速康复要素与翻修手术风险增加显著相关。与感染相关的翻修手术风险与体重指数、身体状况、手术时长、住院时间和假体类型无关。由于局部浸润镇痛、引流管拔除和早期活动是联合引入的，因此无法确定是哪个组成部分或哪些组成部分的组合导致了风险增加。这个小样本的研究结果引发了对快速康复THA的担忧，但需要在其他样本中进行重复验证。
