Meyer Matthias, Kappenschneider Tobias, Grifka Joachim, Weber Markus
Orthopädische Klinik für die Universität Regensburg, Regensburg, Deutschland.
Orthopädische Klinik für die Universität Regensburg, Asklepios Klinikum, Kaiser-Karl V.-Allee 3, 93077, Bad Abbach, Deutschland.
Orthopade. 2022 Feb;51(2):81-90. doi: 10.1007/s00132-021-04206-5. Epub 2022 Jan 7.
Preoperative identification of patients at risk of postoperative complications enables better patient education and surgical planning for the orthopedic surgeon. In addition to demographic and intervention-specific factors, a variety of instruments are available for individual risk assessment. The concept of frailty seems to be promising to identify patients at risk. Modifiable risk factors such as malnutrition, anemia, obesity, smoking, and insufficiently controlled diabetes mellitus are common in elective orthopedic patients. With the use of screening protocols, modifiable risk factors can be identified and optimized preoperatively in order to reduce the individual risk of complications. Recommendations regarding preoperative risk stratification and modification prior to elective hip replacement have meanwhile been incorporated in national guidelines.
术前识别有术后并发症风险的患者，有助于骨科医生更好地开展患者教育和进行手术规划。除了人口统计学因素和特定干预因素外，还有多种工具可用于个体风险评估。虚弱这一概念似乎有望识别出有风险的患者。在择期骨科手术患者中，营养不良、贫血、肥胖、吸烟和糖尿病控制不佳等可改变的风险因素很常见。通过使用筛查方案，可以在术前识别并优化这些可改变的风险因素，以降低个体并发症风险。与此同时，关于择期髋关节置换术前风险分层和调整的建议已纳入国家指南。
