1 Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China.
2 Office of Clinical Epidemiology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
Lupus. 2019 Aug;28(9):1134-1140. doi: 10.1177/0961203319862609. Epub 2019 Jul 11.
In recent years, hip arthroplasty rates in systemic lupus erythematosus (SLE) patients have been increasing rapidly. Although patients with SLE generally show beneficial or desirable functional outcomes following total hip arthroplasty (THA), it has been reported that SLE patients after THA have increased risk of postoperative complications, especially during the period of hospitalization.
In the present study, we aimed to identify possible factors associated with complications or transfusion of THA in SLE patients during hospitalization.
The present study was a retrospective study conducted in Peking Union Medical College Hospital. Data were collected from medical records of patients who underwent THA from January 2012 to June 2018. The primary outcome variable was perioperative complications, which was defined as having one or more of the following conditions: high fever, infection, impaired wound healing, venous thrombosis of the lower extremities, hematoma, arrhythmia, implant complications. The secondary outcome was perioperative transfusion.
During January 2012 to June 2018, 100 patients had taken the surgery of THA. After multivariate analysis, independent risk factors for perioperative complications were: age ≥ 45 years ( = 0.001), SLE with other connective tissue diseases ( = 0.029), high temperature ( = 0.030), positive anti-dsDNA antibody ( = 0.043), and Systemic Lupus International Collaborative Clinics/American College of Rheumatology (SLICC/ACR) Damage Index ≥ 3 ( = 0.008). Independent risk factors for perioperative transfusion were bilateral THA ( = 0.029), low hemoglobin ( = 0.021) and abnormal renal function ( = 0.021).
For SLE patients following THA, age > 45 years, SLE with other connective tissue disease, high temperature, positive anti-dsDNA antibody and SLICC/ACR Damage Index ≥ 3 were the risk factors of complications during hospitalization and bilateral THA, low hemoglobin and abnormal renal function were the risk factors of transfusion.
近年来，系统性红斑狼疮（SLE）患者髋关节置换术（THA）的比例迅速增加。尽管 SLE 患者一般在接受全髋关节置换术后表现出有益或理想的功能结果，但有报道称，THA 后的 SLE 患者术后并发症的风险增加，尤其是在住院期间。
本研究旨在确定与 SLE 患者住院期间 THA 并发症或输血相关的可能因素。
本研究为回顾性研究，在北京协和医院进行。数据来自 2012 年 1 月至 2018 年 6 月期间接受 THA 的患者的病历。主要观察变量为围手术期并发症，定义为出现以下一种或多种情况：高热、感染、伤口愈合不良、下肢静脉血栓形成、血肿、心律失常、植入物并发症。次要观察变量为围手术期输血。
2012 年 1 月至 2018 年 6 月期间，有 100 例患者接受了 THA 手术。多因素分析显示，围手术期并发症的独立危险因素为：年龄≥45 岁（ = 0.001）、SLE 合并其他结缔组织病（ = 0.029）、高热（ = 0.030）、抗 dsDNA 抗体阳性（ = 0.043）、系统性红斑狼疮国际协作组/美国风湿病学会（SLICC/ACR）损伤指数≥3（ = 0.008）。围手术期输血的独立危险因素为双侧 THA（ = 0.029）、低血红蛋白（ = 0.021）和肾功能异常（ = 0.021）。
对于接受 THA 的 SLE 患者，年龄>45 岁、SLE 合并其他结缔组织病、高热、抗 dsDNA 抗体阳性和 SLICC/ACR 损伤指数≥3 是住院期间并发症的危险因素，双侧 THA、低血红蛋白和肾功能异常是输血的危险因素。
