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在一家卓越的三级骨科转诊中心,全膝关节置换术后7年的30天死亡率。

Thirty-day mortality following total knee arthroplasty over 7 years at a tertiary referral centre of orthopaedic excellence.

作者信息

Chan Yuen, Selvaratnam Veenesh, Raut Videsh

机构信息

Mersey Deanery, United Kingdom.

Wrightington Hospital NHS Foundation Trust, United Kingdom.

出版信息

J Clin Orthop Trauma. 2018 Jan-Mar;9(1):51-53. doi: 10.1016/j.jcot.2017.11.018. Epub 2017 Dec 5.

Abstract

Total Knee Arthroplasty (TKA) is one of the most successful orthopaedic procedures. Around 100,000 TKAs are performed yearly in the United Kingdom. The aim of this study was to report the mortality rate within 30 days after a TKA in an Orthopaedic Centre of Excellence. We reviewed prospectively collected data of 7067 TKAs performed between April 2009-November 2016. All mortalities within 30 days of a TKA were recorded. Data such as age, sex, ASA, comorbidities and cause of death was recorded. There were 14 (0.198%) deaths within 30 days of TKA. There were eight male patients and six female patients who died. No statistical difference was demonstrated between gender. (p = 0.37). The mean age was 77.9 years (66-94 years). Means days to death from post-op were 9.6 days (2-30 days). One patient was ASA 1, six patients were ASA 2, six patients were ASA 3 and one patient did not have an ASA recorded. There was no statistical difference between the difference ASA groups. (p = 0.27). Cause of death documented was as follow: acute left ventricular failure-3; myocardial infarction-2; pneumonia-2; pulmonary oedema-1; gastrointestinal bleed-1 and multiorgan failure-1. Four patients did not have their cause of death recorded. The 30-day mortality rate after TKA in our institute is low and is comparable to other institutes. This emphasizes that primary TKA is a safe procedure. The predominant cause of perioperative mortality is cardiopulmonary disease.

摘要

全膝关节置换术(TKA)是最成功的骨科手术之一。在英国,每年大约进行100,000例全膝关节置换术。本研究的目的是报告在一家卓越骨科中心进行全膝关节置换术后30天内的死亡率。我们回顾性分析了2009年4月至2016年11月期间前瞻性收集的7067例全膝关节置换术的数据。记录了全膝关节置换术后30天内的所有死亡病例。记录了年龄、性别、美国麻醉医师协会(ASA)分级、合并症和死亡原因等数据。全膝关节置换术后30天内有14例(0.198%)死亡。死亡患者中有8例男性和6例女性。性别之间未显示出统计学差异(p = 0.37)。平均年龄为77.9岁(66 - 94岁)。术后至死亡的平均天数为9.6天(2 - 30天)。1例患者ASA分级为1级,6例患者为ASA 2级,6例患者为ASA 3级,1例患者未记录ASA分级。不同ASA分级组之间无统计学差异(p = 0.27)。记录的死亡原因如下:急性左心室衰竭 - 3例;心肌梗死 - 2例;肺炎 - 2例;肺水肿 - 1例;胃肠道出血 - 1例;多器官功能衰竭 - 1例。4例患者未记录死亡原因。我们研究所全膝关节置换术后的30天死亡率较低且与其他机构相当。这强调了初次全膝关节置换术是一种安全的手术。围手术期死亡的主要原因是心肺疾病。

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