Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, 676 North St. Clair Street, Suite 1350, Chicago, IL, 60611, USA.
Knee Surg Sports Traumatol Arthrosc. 2020 Apr;28(4):1290-1295. doi: 10.1007/s00167-019-05415-4. Epub 2019 Feb 27.
Hip arthroscopy is known to be safe with low rates of postoperative complications. The purpose of this study is to evaluate hip arthroscopy cases in a national surgical database to identify risk factors associated with readmission.
The American College of Surgeons National Surgical Quality Improvement Program database was queried from 2012 to 2016 for current procedural terminology billing codes related to hip arthroscopy. International Classification of Diseases diagnostic codes were used to exclude cases involving infection, fracture, or open procedures. Univariate and multivariate analyses were performed to identify risk factors associated with 30-day readmission.
1493 patients were identified who had undergone hip arthroscopy. The most common procedures were labral resection or chondroplasty (n = 589, 39.5%) and femoroplasty (n = 527, 35.3%). The 30-day complication rate was 1.7% and the most common complications following the procedure were bleeding (n = 12, 0.8%) superficial infections (n = 5, 0.3%), and returning to the operating room (n = 4, 0.3%). The 30-day readmission rate was 1.3%. On multivariate analysis, hypertension requiring anti-hypertensive medication (odds ratio [OR], 3.5; 95% confidence interval [CI], 1.4-8.7) and chronic corticosteroid or immunosuppressant use (OR 7.2; 95% CI 1.9-26.7) were identified as independent risk factors for readmission. There was no difference in complication rates when hip arthroscopy was performed with isolated femoroplasty (n = 340), isolated acetabuloplasty (n = 103), both (n = 187) or neither (n = 863).
These findings confirm that the 30-day readmission (1.3%) and complication rate (1.7%) are low for isolated hip arthroscopy procedures; however, hypertension and chronic steroid use are independent risk factors for readmission.
Retrospective comparative study, Level III.
髋关节镜检查术已被证实安全,术后并发症发生率低。本研究旨在通过国家外科手术数据库评估髋关节镜检查病例,以确定与再入院相关的危险因素。
2012 年至 2016 年,通过美国外科医师学院国家外科手术质量改进计划数据库,查询与髋关节镜检查相关的当前程序术语计费代码。使用国际疾病分类诊断代码排除涉及感染、骨折或开放性手术的病例。进行单变量和多变量分析,以确定与 30 天再入院相关的危险因素。
共确定 1493 例接受髋关节镜检查的患者。最常见的手术是盂唇切除术或软骨成形术(n=589,39.5%)和股骨成形术(n=527,35.3%)。30 天并发症发生率为 1.7%,术后最常见的并发症是出血(n=12,0.8%)、浅表感染(n=5,0.3%)和再次手术(n=4,0.3%)。30 天再入院率为 1.3%。多变量分析显示,需要抗高血压药物治疗的高血压(比值比[OR],3.5;95%置信区间[CI],1.4-8.7)和慢性皮质类固醇或免疫抑制剂的使用(OR 7.2;95%CI 1.9-26.7)是再入院的独立危险因素。当单独行股骨成形术(n=340)、单独髋臼成形术(n=103)、两者都行(n=187)或两者都不行(n=863)时,髋关节镜检查的并发症发生率没有差异。
这些发现证实,单纯髋关节镜检查的 30 天再入院率(1.3%)和并发症发生率(1.7%)较低;然而,高血压和慢性类固醇的使用是再入院的独立危险因素。
回顾性比较研究,III 级。