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髋关节镜手术量趋势及术后30天并发症

Hip Arthroscopy Surgical Volume Trends and 30-Day Postoperative Complications.

作者信息

Cvetanovich Gregory L, Chalmers Peter N, Levy David M, Mather Richard C, Harris Joshua D, Bush-Joseph Charles A, Nho Shane J

机构信息

Division of Sports Medicine, Rush University Medical Center, Chicago, Illinois, U.S.A..

Division of Sports Medicine, Rush University Medical Center, Chicago, Illinois, U.S.A.

出版信息

Arthroscopy. 2016 Jul;32(7):1286-92. doi: 10.1016/j.arthro.2016.01.042. Epub 2016 Apr 9.

Abstract

PURPOSE

To determine hip arthroscopy surgical volume trends from 2006 to 2013 using the National Surgical Quality Improvement Program (NSQIP) database, the incidence of 30-day complications of hip arthroscopy, and patient and surgical risk factors for complications.

METHODS

Patients who underwent hip arthroscopy from 2006 to 2013 were identified in the NSQIP database for the over 400 NSQIP participating hospitals from the United States using Current Procedural Terminology and International Classification of Diseases, Ninth Revision codes. Trends in number of hip arthroscopy procedures per year were analyzed. Complications in the 30-day period after hip arthroscopy were identified. Univariate and multivariate regression analyses were performed to identify risk factors for complications.

RESULTS

We identified 1,338 patients who underwent hip arthroscopy, with a mean age of 39.5 ± 13.0 years. Female patients comprised 59.6%. Hip arthroscopy procedures became 25 times more common in 2013 than 2006 (P < .001). Major complications occurred in 8 patients (0.6%), and minor complications occurred in 11 patients (0.8%); overall complications occurred in 18 patients (1.3%) (1 patient had 2 complications). The most common complications were bleeding requiring a transfusion (5, 0.4%), return to the operating room (4, 0.3%), superficial infection not requiring return to the operating room (3, 0.2%), deep venous thrombosis (2, 0.1%), and death (2, 0.1%). Multivariate analysis showed that regional/monitored anesthesia care as opposed to general anesthesia (P = .005; odds ratio, 0.102) and a history of patient steroid use (P = .05; odds ratio, 8.346) were independent predictors of minor complications in the 30 days after hip arthroscopy.

CONCLUSIONS

Hip arthroscopy is an increasingly common procedure, with a 25-fold increase from 2006 to 2013. There is a low incidence of 30-day postoperative complications (1.3%), most commonly bleeding requiring a transfusion, return to the operating room, and superficial infection. Regional/monitored anesthesia care and steroid use were independent risk factors for minor complications.

LEVEL OF EVIDENCE

Level III, retrospective comparative study.

摘要

目的

利用国家外科质量改进计划(NSQIP)数据库确定2006年至2013年髋关节镜手术量的趋势、髋关节镜手术30天并发症的发生率以及并发症的患者和手术风险因素。

方法

使用当前手术操作术语和国际疾病分类第九版编码,在NSQIP数据库中识别2006年至2013年期间在美国400多家参与NSQIP的医院接受髋关节镜手术的患者。分析每年髋关节镜手术数量的趋势。确定髋关节镜手术后30天内的并发症。进行单因素和多因素回归分析以确定并发症的风险因素。

结果

我们识别出1338例接受髋关节镜手术的患者,平均年龄为39.5±13.0岁。女性患者占59.6%。2013年髋关节镜手术比2006年常见25倍(P<.001)。8例患者发生严重并发症(0.6%),11例患者发生轻微并发症(0.8%);18例患者发生总体并发症(1.3%)(1例患者有2种并发症)。最常见的并发症是需要输血的出血(5例,0.4%)、返回手术室(4例,0.3%)、无需返回手术室的浅表感染(3例,0.2%)、深静脉血栓形成(2例,0.1%)和死亡(2例,0.1%)。多因素分析显示,与全身麻醉相比,区域/监护麻醉(P=.005;比值比,0.102)和患者使用类固醇激素的病史(P=.05;比值比,8.346)是髋关节镜手术后30天内轻微并发症的独立预测因素。

结论

髋关节镜手术是一种越来越常见的手术,从2006年到2013年增加了25倍。术后30天并发症发生率较低(1.3%),最常见的是需要输血的出血、返回手术室和浅表感染。区域/监护麻醉和类固醇激素使用是轻微并发症的独立风险因素。

证据级别

III级,回顾性比较研究。

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