Bull Hosp Jt Dis (2013). 2020 Dec;78(4):266-274.
Preoperative testing costs billions of dollars despite little evidence supporting its utility. The purpose of this study was to determine the relationship between abnormal preoperative laboratory tests and postoperative complications following total joint arthroplasty.
The NSQIP database was used to identify 45,936 primary total hip arthroplasty (THA) and 76,041 pri-mary total knee arthroplasty (TKA) cases performed between 2006 and 2013. Complications within 30 days of surgery were collected and multivariable regression modeling was performed incorporating all significant laboratory values as well as demographics and preoperative comorbidities.
For THA patients, abnormal sodium (p = 0.016, OR = 1.89), white count (p = 0.043, OR = 1.73), and partial thromboplastin time (p = 0.028, OR = 1.43) were significantly associated with complications. For TKA patients, abnormal alkaline phosphatase (p = 0.04, OR = 2.12), creatinine (p = 0.003, OR = 1.56), and INR (p = 0.008, OR = 1.99) were significantly predictive of complications.
Of the 13 laboratory values, only six were significantly associated with complications. These findings may have implications for risk stratification in the inpatient setting.
尽管术前检查的效用几乎没有证据支持，但它仍耗费了数十亿美元。本研究旨在确定全关节置换术后异常术前实验室检查与术后并发症之间的关系。
利用 NSQIP 数据库，确定了 2006 年至 2013 年间进行的 45936 例初次全髋关节置换术（THA）和 76041 例初次全膝关节置换术（TKA）。收集了术后 30 天内的并发症，并进行了多变量回归建模，纳入了所有显著的实验室值以及人口统计学和术前合并症。
对于 THA 患者，异常的钠（p = 0.016，OR = 1.89）、白细胞计数（p = 0.043，OR = 1.73）和部分凝血活酶时间（p = 0.028，OR = 1.43）与并发症显著相关。对于 TKA 患者，异常的碱性磷酸酶（p = 0.04，OR = 2.12）、肌酐（p = 0.003，OR = 1.56）和 INR（p = 0.008，OR = 1.99）与并发症显著相关。
在 13 个实验室值中，只有 6 个与并发症显著相关。这些发现可能对住院患者的风险分层有影响。
