Choi Hyo Geun, Kwon Bong Cheol, Kim Joong Il, Lee Joon Kyu
Hallym Data Science Laboratory, Hallym University College of Medicine, Gyeonggi-do, Korea.
Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Gyeonggi-do, Korea.
J Orthop Surg (Hong Kong). 2020 Jan-Apr;28(1):2309499020902589. doi: 10.1177/2309499020902589.
Mortality rates and causes of death after total knee arthroplasty (TKA) are of great interest to surgeons. However, there is a shortage of studies regarding those of the Asian population. The aim of this study was to compare the mortality rate and causes of death in patients after TKA to the general population.
National sample cohort data from the Korean Health Insurance Review and Assessment Service were used. In this study, 1:4 matched patients after TKA (TKA group: 5072) and general participants (control group: 20,288) were selected as subjects. Their average follow-up duration was 57.2 months ranging from a year up to 12 years. The matches were processed for age, gender, income, region of residence, and past medical history. Mortality rates and causes of death were compared between groups. Regarding the mortality rates, we also performed subgroup analyses according to age.
Adjusted hazard ratio (HR) of the TKA group for mortality rate was less than 1 with significance (adjusted HR = 0.61 (95% confidence interval = 0.54-0.70, < 0.001)). The ratios were less than 1 for both age groups (<70 and ≥70 years), respectively; however, for patients under 70, they were insignificant. Among the 11 major causes of death, the circulatory disease showed the most significantly reduced mortality rate for the TKA group compared to the control group. The neoplasm was the only other cause with a significantly reduced mortality rate for the TKA group.
The mortality rate in the TKA group was significantly lower than in the control group up to 12 years after the surgery in Korea. Among the major causes of death, circulatory disease and neoplasm showed a significant reduction in the mortality rate of the TKA group compared with the control group.
全膝关节置换术（TKA）后的死亡率和死亡原因是外科医生非常关注的问题。然而，关于亚洲人群的此类研究较少。本研究的目的是比较TKA术后患者与普通人群的死亡率和死亡原因。
使用韩国健康保险审查和评估服务机构的全国样本队列数据。在本研究中，选取1:4匹配的TKA术后患者（TKA组：5072例）和普通参与者（对照组：20288例）作为研究对象。他们的平均随访时间为57.2个月，范围从1年到12年。匹配过程考虑了年龄、性别、收入、居住地区和既往病史。比较两组之间的死亡率和死亡原因。关于死亡率，我们还根据年龄进行了亚组分析。
TKA组死亡率的调整风险比（HR）小于1且具有显著性（调整HR = 0.61（95%置信区间 = 0.54 - 0.70，< 0.001））。两个年龄组（<70岁和≥70岁）的该比值均小于1；然而，对于70岁以下的患者，该比值无显著性。在11种主要死亡原因中，与对照组相比，TKA组循环系统疾病的死亡率降低最为显著。肿瘤是TKA组死亡率显著降低的唯一其他原因。
在韩国，TKA术后长达12年，TKA组的死亡率显著低于对照组。在主要死亡原因中，与对照组相比，TKA组循环系统疾病和肿瘤的死亡率显著降低。
