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身体质量指数作为全膝关节置换术预后的预测指标:一项系统评价和荟萃分析。

Body mass index as a predictor of outcome in total knee replace: A systemic review and meta-analysis.

作者信息

Sun Kai, Li Hui

机构信息

Tianjin First Center Hospital, Fukang Road No. 24, Nankai District, Tianjin 300192, China.

Tianjin Medical University General Hospital, An Shan Road No.154, Heping District, Tianjin 300192, China.

出版信息

Knee. 2017 Oct;24(5):917-924. doi: 10.1016/j.knee.2017.05.022. Epub 2017 Jun 27.

DOI:10.1016/j.knee.2017.05.022
PMID:28666646
Abstract

BACKGROUND

To conduct a meta-analysis with randomized controlled trials (RCTs) published in full text to demonstrate database to show the associations of perioperative, postoperative outcomes of normal and high body mass index (BMI) to provide the predictive diagnosis for clinic.

METHODS

Literature search was performed in PubMed, Embase, Web of Science and Cochrane Library for information from the earliest date of data collection to February. RCTs comparing the benefits and risks of normal BMI with those of high BMI in primary total knee arthroplasty (TKA) were included. Statistical heterogeneity was quantitatively evaluated by X2 test with the significance set P<0.10 or I>50%.

RESULTS

Seven RCTs consisting of 33,778 patients were included. (6065 normal BMI patient; 27,713 high BMI). The results showed that high BMI was related to a greater increase in operative time, post-operative range of motion (ROM), post-operative Knee Society and function scores (KSS), infection rate (P<0.1). No differences in pulmonary embolism and perioperative mortality rates were found between normal and high body mass index patients with follow-up≥5years (P>0.1).

CONCLUSIONS

Compared with normal BMI patients, high BMI patients demonstrated an increased risk of perioperative and postoperative complications and clear difference about complications between normal and high BMI about TKA.

摘要

背景

通过对全文发表的随机对照试验(RCT)进行荟萃分析,以论证数据库,展示正常和高体重指数(BMI)患者围手术期、术后结果的相关性,为临床提供预测性诊断。

方法

在PubMed、Embase、Web of Science和Cochrane图书馆进行文献检索,获取从数据收集最早日期至2月的信息。纳入比较初次全膝关节置换术(TKA)中正常BMI与高BMI患者利弊的RCT。采用X2检验对统计异质性进行定量评估,显著性设定为P<0.10或I>50%。

结果

纳入7项RCT,共33778例患者(6065例正常BMI患者;27713例高BMI患者)。结果显示,高BMI与手术时间增加、术后活动范围(ROM)、术后膝关节协会和功能评分(KSS)增加、感染率升高相关(P<0.1)。随访≥5年的正常和高体重指数患者在肺栓塞和围手术期死亡率方面无差异(P>0.1)。

结论

与正常BMI患者相比,高BMI患者围手术期和术后并发症风险增加,且TKA中正常和高BMI患者在并发症方面存在明显差异。

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