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肘管尺神经松解术后感染的患者相关危险因素:15188例病例分析

Patient-Related Risk Factors for Infection Following Ulnar Nerve Release at the Cubital Tunnel: An Analysis of 15,188 Cases.

作者信息

Camp Christopher L, Tebo Collin C, Degen Ryan M, Dines Joshua S, Altchek David W, Werner Brian C

机构信息

Sports Medicine Center, Department of Orthopedics, Mayo Clinic, Rochester, Minnesota, USA.

Weill-Cornell Medical School, Cornell University, New York, New York, USA.

出版信息

Orthop J Sports Med. 2018 May 15;6(5):2325967118772799. doi: 10.1177/2325967118772799. eCollection 2018 May.

Abstract

BACKGROUND

Although cubital tunnel release is a commonly performed orthopaedic procedure, the overall incidence of and independent risk factors for infection largely remain undefined in the current literature.

PURPOSE

To establish the rate of postoperative infection after isolated cubital tunnel release and define relevant patient-related risk factors.

STUDY DESIGN

Case-control study; Level 3.

METHODS

All Medicare-insured patients undergoing ulnar nerve decompression at the cubital tunnel from 2010 through 2012 were identified. A multivariate binomial logistic regression analysis was utilized to evaluate the impact of patient-related risk factors for postoperative infection.

RESULTS

A total of 330 (2.17%) postoperative infections were identified in 15,188 cases. The majority (87%) were managed nonoperatively, while 13% required surgical debridement. The most significant risk factors for infection included hemodialysis use (odds ratio [OR], 2.47), chronic anemia (OR, 2.24), age <65 years (OR, 2.08), tobacco use (OR, 1.65), morbid obesity (OR, 1.53), inflammatory arthritis (OR, 1.43), depression (OR, 1.36), hyperlipidemia (OR, 1.33), male sex (OR, 1.32), and chronic lung disease (OR, 1.29).

CONCLUSION

The present study was adequately powered to determine numerous patient-related risk factors for infection following cubital tunnel release.

摘要

背景

尽管肘管松解术是一种常见的骨科手术,但目前文献中感染的总体发生率及独立危险因素仍大多未明确。

目的

确定单纯肘管松解术后的感染率,并明确相关的患者相关危险因素。

研究设计

病例对照研究;3级。

方法

确定2010年至2012年期间所有接受肘管尺神经减压术的医疗保险患者。采用多变量二项逻辑回归分析来评估患者相关危险因素对术后感染的影响。

结果

在15188例病例中,共发现330例(2.17%)术后感染。大多数(87%)采用非手术治疗,而13%需要手术清创。最显著的感染危险因素包括使用血液透析(比值比[OR],2.47)、慢性贫血(OR,2.24)、年龄<65岁(OR,2.08)、吸烟(OR,1.65)、病态肥胖(OR,1.53)、炎性关节炎(OR,1.43)、抑郁症(OR,1.36)、高脂血症(OR,1.33)、男性(OR,1.32)和慢性肺病(OR,1.29)。

结论

本研究有足够的效力来确定肘管松解术后感染的众多患者相关危险因素。

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