全肩关节置换术的人口统计学、发病率及并发症——一项全国住院患者样本数据库研究
Total Shoulder Arthroplasty Demographics, Incidence, and Complications-A Nationwide Inpatient Sample Database Study.
作者信息
Issa Kimona, Pierce Casey M, Pierce Todd P, Boylan Matthew R, Zikria Bashir A, Naziri Qais, Festa Anthony, McInerney Vincent K, Scillia Anthony J
机构信息
Department of Orthopaedics, Seton Hall University, School of Health and Medical Sciences, South Orange, NJ.
Department of Orthopaedic Surgery, SUNY Downstate Medical Center, Brooklyn, NY.
出版信息
Surg Technol Int. 2016 Oct 26;29:240-246.
INTRODUCTION
Total shoulder arthroplasty (TSA) has become a popular and successful surgery to treat advanced glenohumeral arthritis, rotator cuff arthropathy, and proximal humerus fractures. Historical data is available investigating the epidemiology of total shoulder arthroplasty with regard to patient characteristics, outcomes, and complications; however, there is a lack of studies investigating the most recent and up to date national trends related to shoulder replacement. The purpose of this study was to evaluate changes in the annual incidence, various demographics, and complications of TSA in America.
MATERIALS AND METHODS
The Nationwide Inpatient Sample (NIS) was assessed to identify all patients who were admitted for TSA in the United States between 1998 and 2010. National trends in patient demographics, incidence, and length-of-stay (LOS) were analyzed for correlations. The impacts of contributing factors to each outcome were assessed using adjusted multivariable regression analysis. These were used to calculate odds ratios of cohort demographics and their association with complications and LOS.
RESULTS
Admissions for TSA have risen (8,041 to 39,072 admissions). The majority of the cohort consisted of Caucasian men between the ages of 64 and 79 years. The incidence rate of complications has remained consistent. Female gender, age > 80 years, and higher Deyo Comorbidity scores were risk factors for higher complications. The LOS has decreased (2.96 to 2.21 days) during the study time period. Female gender, African-American race, Medicaid insurance, and higher Deyo Comorbidity scores were associated with longer stays.
DISCUSSION
Our study demonstrates a rapid increase in incidence rates of TSAs within the 13-year period in the United States. An increased risk of complications was noted with older age, female gender, and increased Deyo score.
CONCLUSION
Our findings may help health care providers identify ways to better manage this procedure and select patients.
引言
全肩关节置换术（TSA）已成为治疗晚期盂肱关节炎、肩袖关节病和肱骨近端骨折的一种流行且成功的手术。有历史数据研究了全肩关节置换术在患者特征、疗效和并发症方面的流行病学情况；然而，缺乏关于肩关节置换术最新全国趋势的研究。本研究的目的是评估美国全肩关节置换术的年发病率、各种人口统计学特征和并发症的变化。
材料与方法
评估全国住院患者样本（NIS），以确定1998年至2010年间在美国因全肩关节置换术入院的所有患者。分析患者人口统计学特征、发病率和住院时间（LOS）的全国趋势以寻找相关性。使用调整后的多变量回归分析评估各因素对每个结果的影响。这些用于计算队列人口统计学特征的比值比及其与并发症和住院时间的关联。
结果
全肩关节置换术的入院人数有所增加（从8041例增至39072例）。队列中的大多数患者为64至79岁的白人男性。并发症的发生率保持稳定。女性、年龄>80岁以及较高的戴约合并症评分是并发症发生率较高的危险因素。在研究期间，住院时间有所缩短（从2.96天降至2.21天）。女性、非裔美国人种族、医疗补助保险和较高的戴约合并症评分与住院时间较长有关。
讨论
我们的研究表明，在美国13年期间全肩关节置换术的发病率迅速增加。注意到年龄较大、女性以及戴约评分增加会使并发症风险增加。
结论
我们的研究结果可能有助于医疗保健提供者确定更好地管理该手术和选择患者的方法。
Zotero 插件