University of Kansas School of Medicine, Kansas City, USA.
Texas Tech University Health Sciences Center, El Paso, USA.
Hand (N Y). 2023 Jan;18(1_suppl):154S-160S. doi: 10.1177/15589447211044768. Epub 2021 Sep 21.
To identify the rate of 30-day complications after primary repair of upper extremity peripheral nerve injuries, associated diagnoses, and postoperative complication rate.
The American College of Surgeons National Surgical Quality Improvement Program database was reviewed from 2010 to 2016. Current Procedural Terminology codes consistent with primary nerve repair of the upper extremity were identified and included in the analysis. Patient demographics, comorbidities, type of procedure (elective/emergent), wound class, operative time, and 30-day complications were recorded. Patients with isolated upper extremity nerve injuries (isolated) were compared with those with peripheral nerve injuries in addition to bone, tendon, or soft tissue injuries (multiple).
In all, 785 patients were identified as having upper extremity nerve repairs (0.16%). Of them, 64% were men and 36% were women; the average patient age was 40 years. The most common indication for surgery was injury to the digits (54% of cases). Thirty-day adverse events occurred in 3% of all cases. Isolated nerve injury occurred in 43% of patients, whereas 57% had additional injuries. The multiple injury group had a significantly higher complication rate compared with the isolated group (1% vs 4.5%) ( = .007). Repair of tendon at forearm or wrist was the most common concurrent procedure performed.
Thirty-day complications among upper extremity peripheral nerve injuries are low, accounting for 3% of cases. Return to the operating room accounted for nearly half of all complications. Patients in the multiple injury group accounted for more than half of these and had a significantly higher complication rate compared with patients with isolated nerve injuries.
确定上肢周围神经损伤初次修复后 30 天并发症的发生率、相关诊断和术后并发症发生率。
回顾了 2010 年至 2016 年美国外科医师学会国家外科质量改进计划数据库。确定了与上肢主要神经修复一致的美国外科医师学会现行手术操作分类代码，并将其纳入分析。记录了患者的人口统计学资料、合并症、手术类型（择期/急诊）、伤口分类、手术时间和 30 天并发症。将单纯上肢神经损伤患者（单纯组）与伴有骨、肌腱或软组织损伤的上肢周围神经损伤患者（多发组）进行比较。
共确定了 785 例上肢神经修复患者（0.16%）。其中，64%为男性，36%为女性；平均患者年龄为 40 岁。手术最常见的指征是手指损伤（54%的病例）。所有病例中有 3%发生了 30 天不良事件。单纯神经损伤患者占 43%，而 57%的患者有其他损伤。多发组的并发症发生率明显高于单纯组（1%比 4.5%）（=0.007）。在前臂或腕部修复肌腱是最常见的同时进行的手术。
上肢周围神经损伤 30 天并发症发生率较低，占 3%。返回手术室的患者占所有并发症的近一半。多发组的患者占了其中的一半以上，与单纯神经损伤患者相比，其并发症发生率明显更高。
