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关节镜下Bankart修复术后住院的危险因素。

Risk Factors for Hospital Admission Following Arthroscopic Bankart Repair.

作者信息

DeFroda Steven F, Bokshan Steven L, Owens Brett D

出版信息

Orthopedics. 2017 Sep 1;40(5):e855-e861. doi: 10.3928/01477447-20170719-04. Epub 2017 Aug 4.

Abstract

Arthroscopic Bankart repair, a commonly performed procedure in the United States, is usually done on an outpatient basis. All instances of arthroscopic Bankart repair from 2005 to 2014 from the American College of Surgeons National Surgical Quality Improvement Program prospective database were analyzed. Both univariate analysis and binary logistic regression were performed to determine risk factors for admission following surgery. Of 2291 patients undergoing arthroscopic Bankart repair, 173 (7.6%) required inpatient hospital admission following surgery. Univariate analysis found the following to be associated with admission: female sex (P=.009), age older than 40 years (P<.001), white race (P=.002), body mass index greater than 30 kg/m (P=.001), and American Society of Anesthesiologists class greater than 3 (P<.001). Independent predictors of admission on multivariate analysis included female sex (odds ratio [OR], 1.58; 95% confidence interval [CI], 1.06-2.10; P=.023), increasing age (per year) (OR, 1.03; 95% CI, 1.02-1.04; P<.001), diabetes (OR, 2.70; 95% CI, 2.30-3.10; P=.006), and longer operation time (per minute) (OR, 1.010; 95% CI, 1.009-1.011; P<.001). This study identified a 7.6% rate of admission following arthroscopic Bankart repair, with diabetes, female sex, increasing age, and longer operation time being independent risk factors for admission. Knowledge of these risk factors is important when setting patient expectations preoperatively and for optimizing care to obtain the best short-term outcome. [Orthopedics. 2017; 40(5):e855-e861.].

摘要

关节镜下Bankart修复术是美国一种常见的手术,通常在门诊进行。对美国外科医师学会国家外科质量改进计划前瞻性数据库中2005年至2014年所有关节镜下Bankart修复术病例进行了分析。采用单因素分析和二元逻辑回归分析来确定术后住院的危险因素。在2291例行关节镜下Bankart修复术的患者中,173例(7.6%)术后需要住院治疗。单因素分析发现以下因素与住院有关:女性(P = 0.009)、年龄大于40岁(P < 0.001)、白种人(P = 0.002)、体重指数大于30 kg/m²(P = 0.001)以及美国麻醉医师协会分级大于3级(P < 0.001)。多因素分析中住院的独立预测因素包括女性(优势比[OR],1.58;95%置信区间[CI],1.06 - 2.10;P = 0.023)、年龄增长(每年)(OR,1.03;95% CI,1.02 - 1.04;P < 0.001)、糖尿病(OR,2.70;95% CI,2.30 - 3.10;P = 0.006)以及手术时间延长(每分钟)(OR,1.010;95% CI,1.009 - 1.011;P < 0.001)。本研究确定关节镜下Bankart修复术后的住院率为7.6%,糖尿病、女性、年龄增长和手术时间延长是住院的独立危险因素。了解这些危险因素对于术前设定患者预期以及优化护理以获得最佳短期结果非常重要。[《骨科》。2017;40(5):e855 - e861。]

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