Sveom Daniel S, Otteman Mary K, Garvin Kevin L
Department of Orthopaedic Surgery and Rehabilitation, 985640 Nebraska Medical Center, Omaha, NE, 68198-5640, USA.
Curr Rev Musculoskelet Med. 2017 Sep;10(3):388-396. doi: 10.1007/s12178-017-9424-5.
Total joint arthroplasty (TJA) has had an increased demand over the recent years. It is a successful procedure, and there are relatively few complications, but there is a high overall cost. There is a push to increase the quality of care, lessen complications, and decrease cost by reducing readmissions. This article will discuss the risk factors that can contribute to the complication and readmission rates following TJA.
Several risk factors have been found to contribute to the complication and readmission rates following a TJA. It is important to understand these risk factors and mitigate them as much as possible in order to optimize the patient experience. There are risk factors that cannot be modified, and the treatment team as well as the patient should be made aware of these and account for them when making the decision whether to undergo elective primary TJA or not. In general, an increased number of risk factors is associated with increased complications and increased readmission rates. At our institution, we have used this knowledge to improve our outcomes and decrease costs. It is important to be mindful of risk factors for poor outcomes prior to performing TJA. This allows for the optimization of patients prior to undergoing surgery. This can lead to improved outcomes at a lower cost.
近年来,全关节置换术(TJA)的需求不断增加。这是一种成功的手术,并发症相对较少,但总体成本较高。目前正在推动提高护理质量、减少并发症并通过减少再入院来降低成本。本文将讨论可能导致TJA术后并发症和再入院率的危险因素。
已发现多种危险因素会导致TJA术后出现并发症和再入院情况。了解这些危险因素并尽可能减轻它们,对于优化患者体验非常重要。有些危险因素无法改变,治疗团队和患者都应了解这些因素,并在决定是否进行择期初次TJA时予以考虑。一般来说,危险因素数量增加与并发症增多和再入院率升高相关。在我们机构,我们利用这些知识改善了治疗效果并降低了成本。在进行TJA之前,留意不良预后的危险因素很重要。这有助于在手术前优化患者情况。这可以以更低的成本带来更好的治疗效果。