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翻修肩关节置换术的危险因素及并发症

Risk Factors and Complications for Revision Shoulder Arthroplasty.

作者信息

Leong Natalie L, Sumner Shelby, Gowd Ani, Nicholson Gregory P, Romeo Anthony A, Verma Nikhil N

机构信息

1University of Maryland Medical Center, 300 S. Paca St., Baltimore, MD 21201 USA.

2Baltimore Veterans Administration Medical Center, 10 N. Greene St., Baltimore, MD 21201 USA.

出版信息

HSS J. 2020 Feb;16(1):9-14. doi: 10.1007/s11420-019-09673-3. Epub 2019 Feb 28.

Abstract

BACKGROUND

Revision shoulder arthroplasty has become increasingly common as primary arthroplasty has become more widespread.

QUESTIONS/PURPOSES: We sought to answer two questions: What are the risks factors for revision shoulder arthroplasty? What are the complications associated with revision shoulder arthroplasty?

METHODS

A retrospective search of a national insurance database from the years 2013 to 2016 was undertaken for billing codes of patients undergoing revision shoulder arthroplasty. The odds ratios for revision of various patient demographic characteristics and comorbidities were determined. The incidences of various complications within 90 days of revision were determined.

RESULTS

A total of 824 cases of revision shoulder arthroplasty were found. Eighty-seven patients (10.5%) had infections prior to revision and 133 patients (16.1%) had dislocations prior to revision. Of the risk factors examined, smoking status was associated with the highest odds ratio for revision (8.1). Additionally, depression, Charlson Comorbidity Index (CCI), male gender, renal failure, and diabetes were significant risks factors for revision. The most common complication of revision shoulder arthroplasty was found to be surgical site infection, affecting 10.9% of patients. In the time period studied, 89 patients underwent more than one revision shoulder arthroplasty.

CONCLUSION

Despite limitations inherent in database studies, this data may have utility for surgeons in pre-operative counseling of patients on their risk.

摘要

背景

随着初次关节置换术越来越普遍,翻修肩关节置换术也变得越来越常见。

问题/目的:我们试图回答两个问题:翻修肩关节置换术的风险因素有哪些?与翻修肩关节置换术相关的并发症有哪些?

方法

对2013年至2016年全国保险数据库进行回顾性检索,以查找接受翻修肩关节置换术患者的计费代码。确定了各种患者人口统计学特征和合并症的翻修比值比。确定了翻修后90天内各种并发症的发生率。

结果

共发现824例翻修肩关节置换术病例。87例患者(10.5%)在翻修前有感染,133例患者(16.1%)在翻修前有脱位。在所检查的风险因素中,吸烟状况与最高的翻修比值比相关(8.1)。此外,抑郁症、查尔森合并症指数(CCI)、男性、肾衰竭和糖尿病是翻修的重要风险因素。翻修肩关节置换术最常见的并发症是手术部位感染,影响了10.9%的患者。在研究期间,89例患者接受了不止一次翻修肩关节置换术。

结论

尽管数据库研究存在固有局限性,但这些数据可能有助于外科医生在术前为患者提供风险咨询。

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