Giladi Aviram M, Rahgozar Paymon, Zhong Lin, Chung Kevin C
1 Hand Surgery and Plastic Surgery, MedStar Union Memorial Hospital, Baltimore, MD, USA.
2 Department of Surgery, University of California San Francisco Medical Center, San Francisco, CA, USA.
J Hand Surg Eur Vol. 2018 Dec;43(10):1106-1110. doi: 10.1177/1753193418805391. Epub 2018 Oct 18.
Truven MarketScan® Databases were used to identify patients with thumb carpometacarpal arthritis who underwent surgical treatment. Pre-operative corticosteroid or hyaluronic acid injections were identified, as were post-operative complications. Multivariable regressions assessed the relationship between injections and complications. Of 16,268 patients, 4462 had steroid injections and 252 received hyaluronic acid injections. Twenty-one per cent (3381 patients) had post-operative complications. Diabetes and smoking increased the odds of complications in all models. Odds of any complication, most notably infectious complications, were increased 20% by corticosteroids (OR 1.2; 95% CI: 1.1 to 1.3). More than three injections increased the odds of a complication by 70% (OR 1.7; 95% CI: 1.3 to 2.1). Hyaluronic acid increased the odds of wound-healing complications by 110% (OR 2.1; 95% CI: 1.3 to 3.4). Corticosteroid and hyaluronic acid injections for thumb carpometacarpal arthritis increase the odds of post-operative complications. Level of evidence: IV.
利用Truven MarketScan®数据库识别接受手术治疗的拇指腕掌关节炎患者。确定术前皮质类固醇或透明质酸注射情况以及术后并发症情况。多变量回归分析评估注射与并发症之间的关系。在16268例患者中，4462例接受了类固醇注射，252例接受了透明质酸注射。21%（3381例患者）出现术后并发症。在所有模型中，糖尿病和吸烟会增加并发症发生几率。皮质类固醇使任何并发症（最显著的是感染性并发症）的发生几率增加20%（比值比1.2；95%置信区间：1.1至1.3）。注射超过三次会使并发症发生几率增加70%（比值比1.7；95%置信区间：1.3至2.1）。透明质酸使伤口愈合并发症的发生几率增加110%（比值比2.1；95%置信区间：1.3至3.4）。拇指腕掌关节炎患者注射皮质类固醇和透明质酸会增加术后并发症发生几率。证据级别：IV级。
