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术前贫血对全肩关节置换术后并发症的影响。

The Impact of Preoperative Anemia on Complications After Total Shoulder Arthroplasty.

机构信息

From the Renaissance School of Medicine at Stony Brook University (Mr. Kashanchi), and the Department of Orthopaedics, Stony Brook University (Dr. Nazemi, Dr. Komatsu, and Dr. Wang), Stony Brook, NY.

出版信息

J Am Acad Orthop Surg Glob Res Rev. 2021 Jan 19;5(1):e20.00136. doi: 10.5435/JAAOSGlobal-D-20-00136.

DOI:10.5435/JAAOSGlobal-D-20-00136
PMID:33512965
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7819688/
Abstract

BACKGROUND

This study investigated the relationship between varying levels of preoperative anemia and postoperative complications within 30 days of total shoulder arthroplasty (TSA).

METHODS

All patients who underwent TSA from 2015 to 2017 were queried from the American College of Surgeons National Surgical Quality Improvement database. Patients were categorized based on preoperative hematocrit levels: normal (>39% for men and >36% for women), mild anemia (29% to 39% for men and 29% to 36% for women), and severe anemia (<29% for both men and women).

RESULTS

A total of 10,547 patients were included in the study. Of these patients, 1,923 patients were (18.2%) in the mild anemia cohort and 146 (1.4%) were in the severe anemia cohort. Mild anemia was identified as a significant predictor of any complication (odds ratio [OR] 2.74, P < 0.001), stroke/cerebrovascular accident (OR 6.79, P = 0.007), postoperative anemia requiring transfusion (OR 6.58, P < 0.001), nonhome discharge (OR 1.79, P < 0.001), readmission (OR 1.63, P < 0.001), and return to the surgical room (OR 1.60, P = 0.017). Severe anemia was identified as a significant predictor of any complication (OR 4.31, P < 0.001), renal complication (OR 13.78, P < 0.001), postoperative anemia requiring transfusion (OR 5.62, P < 0.001), and nonhome discharge (OR 2.34, P < 0.001).

CONCLUSION

Preoperative anemia status is a risk factor for complications within 30 days of TSA.

摘要

背景

本研究调查了全肩关节置换术（TSA）术后 30 天内不同程度术前贫血与术后并发症之间的关系。

方法

从美国外科医师学会国家手术质量改进数据库中查询了 2015 年至 2017 年期间接受 TSA 的所有患者。根据术前血细胞比容水平将患者分为以下几类：正常（男性>39%，女性>36%）、轻度贫血（男性 29%至 39%，女性 29%至 36%）和重度贫血（男女均<29%）。

结果

共有 10547 例患者纳入研究。其中 1923 例（18.2%）患者为轻度贫血组，146 例（1.4%）患者为重度贫血组。轻度贫血是任何并发症（比值比[OR]2.74，P<0.001）、中风/脑血管意外（OR 6.79，P=0.007）、术后贫血需要输血（OR 6.58，P<0.001）、非家庭出院（OR 1.79，P<0.001）、再入院（OR 1.63，P<0.001）和返回手术室（OR 1.60，P=0.017）的显著预测因素。重度贫血是任何并发症（OR 4.31，P<0.001）、肾脏并发症（OR 13.78，P<0.001）、术后贫血需要输血（OR 5.62，P<0.001）和非家庭出院（OR 2.34，P<0.001）的显著预测因素。

结论

术前贫血状态是 TSA 术后 30 天内并发症的危险因素。