Institute of Medical Science, University of Toronto, Toronto, Canada.
London Health Sciences Centre, London, Canada.
Bone Joint J. 2019 Jun;101-B(6_Supple_B):51-56. doi: 10.1302/0301-620X.101B6.BJJ-2018-1400.R1.
The aim of this study was to assess the influence of operating time on 30-day complications following total hip arthroplasty (THA).
We identified patients aged 18 years and older who underwent THA between 2006 and 2016 from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database. We identified 131 361 patients, with a mean age of 65 years (sd 12), who underwent THA. We used multivariable regression to determine if the rate of complications and re-admissions was related to the operating time, while adjusting for relevant covariables.
The mean operating time decreased from 118.3 minutes (29.0 to 217.0) in 2006, to 89.6 minutes (20.0 to 240.0) in 2016. After adjustment for covariables, operating times of between 90 and 119 minutes increased the risk of minor complications by 1.2 (95% confidence interval (CI) 1.1 to 1.3), while operating times of between 120 and 179 minutes increased the risk of major complications by 1.4 (95% CI 1.3 to 1.6) and minor complications by 1.4 (95% CI 1.2 to 1.5), and operating times of 180 minutes or more increased the risk of major complications by 2.1 (95% CI 1.8 to 2.6) and minor complications by 1.9 (95% CI 1.6 to 2.3). There was no difference in the overall risk of complications for operating times of between 20 and 39, 40 and 59, or 60 and 89 minutes (p > 0.05). Operating times of between 40 and 59 minutes decreased the risk of re-admission by 0.88 (95% CI 0.79 to 0.97), while operating times of between 120 and 179 minutes, and of 180 minutes or more, increased the risk of re-admission by 1.2 (95% CI 1.1 to 1.3) and 1.6 (95% CI 1.3 to 1.8), respectively.
These findings suggest that an operating time of more than 90 minutes may be an independent predictor of major and minor complications, as well as re-admission, following THA, and that an operating time of between 40 and 90 minutes may be ideal. Prospective studies are required to confirm these findings. Cite this article: 2019;101-B(6 Supple B):51-56.
本研究旨在评估全髋关节置换术（THA）后手术时间对 30 天内并发症的影响。
我们从美国外科医师学会国家手术质量改进计划（NSQIP）数据库中确定了 2006 年至 2016 年间年龄在 18 岁及以上接受 THA 的患者。我们确定了 131361 名平均年龄为 65 岁（标准差 12）的患者接受了 THA。我们使用多变量回归来确定并发症和再入院的发生率是否与手术时间有关，同时调整了相关协变量。
手术时间从 2006 年的 118.3 分钟（29.0 至 217.0）逐渐减少至 2016 年的 89.6 分钟（20.0 至 240.0）。在调整了协变量后，手术时间在 90 至 119 分钟之间会使轻微并发症的风险增加 1.2（95%置信区间（CI）为 1.1 至 1.3），而手术时间在 120 至 179 分钟之间会使严重并发症的风险增加 1.4（95%CI 为 1.3 至 1.6）和轻微并发症的风险增加 1.4（95%CI 为 1.2 至 1.5），手术时间超过 180 分钟会使严重并发症的风险增加 2.1（95%CI 为 1.8 至 2.6）和轻微并发症的风险增加 1.9（95%CI 为 1.6 至 2.3）。手术时间在 20 至 39、40 至 59 和 60 至 89 分钟之间的并发症总体风险无差异（p＞0.05）。手术时间在 40 至 59 分钟之间可使再入院风险降低 0.88（95%CI 为 0.79 至 0.97），而手术时间在 120 至 179 分钟和 180 分钟或更长时间会使再入院风险分别增加 1.2（95%CI 为 1.1 至 1.3）和 1.6（95%CI 为 1.3 至 1.8）。
这些发现表明，手术时间超过 90 分钟可能是 THA 后严重和轻微并发症以及再入院的独立预测因素，而手术时间在 40 至 90 分钟之间可能是理想的。需要前瞻性研究来证实这些发现。
2019;101-B（6 增刊 B）：51-56。
