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全膝关节置换术后并发症的季节影响

Seasonal Influence on Postoperative Complications after Total Knee Arthroplasty.

作者信息

Malik Azeem Tariq, Azmat Shahid Khan, Ali Arif, Mufarrih Syed Hamza, Noordin Shahryar

机构信息

Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

Section of Orthopaedic Surgery, Department of Surgery, Aga Khan University, Karachi, Pakistan.

出版信息

Knee Surg Relat Res. 2018 Mar 1;30(1):42-49. doi: 10.5792/ksrr.17.052.

Abstract

PURPOSE

This study is aimed at investigating whether inpatient complications and surgical site infections (SSIs) occurred more commonly in patients undergoing total knee arthroplasty (TKA) during the summer season.

MATERIALS AND METHODS

A total of 725 patients who underwent unilateral or bilateral TKA were included in this study. A total of 241 patients (33.2%) underwent TKA between May and August. Our outcomes of interest were the incidence of postoperative complications and length of stay.

RESULTS

May-August surgeries were associated with a higher risk of postoperative inpatient complications (p=0.003). May-August surgeries (odds ratio [OR], 2.13; 95% confidence interval [CI], 1.18 to 3.85), postoperative transfusion (OR, 2.46; 95% CI, 1.43 to 4.26), postoperative special care unit stay (OR, 4.68; 95% CI, 1.99 to 11.0) and chronic kidney disease (OR, 3.27; 95% CI, 1.15 to 9.28) were associated with a higher odds of developing inpatient complications. No association was present between summer surgeries and SSIs (p=0.486).

CONCLUSIONS

The results of this study show that overall complication rates following TKA exhibit a seasonal trend, with a peak during the summer months. These results may have some implication in clinical practice and stricter approaches to hospital guidelines during the summer months.

摘要

目的

本研究旨在调查全膝关节置换术(TKA)患者在夏季是否更常发生住院并发症和手术部位感染(SSI)。

材料与方法

本研究纳入了725例行单侧或双侧TKA的患者。共有241例患者(33.2%)在5月至8月期间接受了TKA。我们感兴趣的结果是术后并发症的发生率和住院时间。

结果

5月至8月进行的手术与术后住院并发症的较高风险相关(p = 0.003)。5月至8月进行的手术(优势比[OR],2.13;95%置信区间[CI],1.18至3.85)、术后输血(OR,2.46;95%CI,1.43至4.26)、术后在特殊护理病房的停留时间(OR,4.68;95%CI,1.99至11.0)和慢性肾病(OR,3.27;95%CI,1.15至9.28)与发生住院并发症的较高几率相关。夏季手术与SSI之间无关联(p = 0.486)。

结论

本研究结果表明,TKA后的总体并发症发生率呈现季节性趋势,在夏季月份达到峰值。这些结果可能对临床实践有一定启示,并在夏季月份采取更严格的医院指南方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3600/5853166/88ebfcd3117f/ksrr-30-042f1.jpg

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