Lovecchio Francis C, Manalo John Paul, Demzik Alysen, Sahota Shawn, Beal Matthew, Manning David
Orthopedics. 2017 May 1;40(3):171-176. doi: 10.3928/01477447-20170117-03. Epub 2017 Jan 23.
Avascular necrosis (AVN) may confer an increased risk of complications and readmission following total hip arthroplasty (THA). However, current risk-adjustment models do not account for AVN. A total of 1706 patients who underwent THA for AVN from 2011 to 2013 were selected from the American College of Surgeon's National Surgical Quality Improvement Program database and matched 1:1 to controls using a predetermined propensity score algorithm. Rates of 30-day medical and surgical complications, readmissions, and reoperations were compared between cohorts. Propensity-score logistic regression was used to determine independent associations between AVN and outcomes of interest. Patients with AVN had a higher rate of medical complications than those without AVN (20.3% vs 15.3%, respectively; P<.001). Bleeding transfusion was the most common medical complication, occurring at a significantly higher rate in patients with AVN than those without AVN (19.6% vs 13.9%, respectively; P<.001). Patients with AVN were also twice as likely to experience a readmission after THA (odds ratio, 2.093; 95% confidence interval, 1.385-3.164). Avascular necrosis of the femoral head is an independent risk factor for transfusion up to 72 hours postoperatively and readmission up to 30 days following total hip replacement. [Orthopedics. 2017; 40(3):171-176.].
股骨头缺血性坏死（AVN）可能会增加全髋关节置换术（THA）后并发症和再入院的风险。然而，目前的风险调整模型并未考虑AVN因素。从美国外科医师学会国家外科质量改进计划数据库中选取了2011年至2013年因AVN接受THA的1706例患者，并使用预定的倾向评分算法将其与对照组进行1:1匹配。比较了两组患者30天内的医疗和手术并发症、再入院及再次手术的发生率。采用倾向评分逻辑回归分析来确定AVN与感兴趣结局之间的独立关联。AVN患者的医疗并发症发生率高于非AVN患者（分别为20.3%和15.3%；P<0.001）。输血是最常见的医疗并发症，AVN患者的发生率显著高于非AVN患者（分别为19.6%和13.9%；P<0.001）。AVN患者THA后再入院的可能性也高出两倍（比值比，2.093；95%置信区间，1.385 - 3.164）。股骨头缺血性坏死是全髋关节置换术后72小时内输血及30天内再入院的独立危险因素。[《骨科学》。2017年；40(3):171 - 176。]
