儿童和青少年前交叉韧带重建术后的感染率：一项 44501 例患者的 MarketScan 数据库研究。
Rates of Infection After ACL Reconstruction in Pediatric and Adolescent Patients: A MarketScan Database Study of 44,501 Patients.
机构信息
Department of Orthopaedic Surgery.
Division of Infectious Diseases, Center for Administrative Data Research.
出版信息
J Pediatr Orthop. 2022 Apr 1;42(4):e362-e366. doi: 10.1097/BPO.0000000000002080.
BACKGROUND
Numerous studies have demonstrated an increase in the number of anterior cruciate ligament (ACL) reconstruction procedures performed in pediatric patients. Despite this, most knowledge of surgical site infection rates after these procedures are based on adult studies and data is currently limited in pediatric patients. The purpose of this study was to describe and analyze the rates of infection after ACL reconstruction among pediatric patients and adolescent patients (compared with young adult patients) utilizing the MarketScan Commercial Claims and Encounters Database.
METHODS
The Truven Health Analytics MarketScan Commercial Claims and Encounters database was assessed to access health care utilization data for privately insured individuals aged 5 to 30 years old. ACL reconstruction records performed between 2006 and 2018 were identified using Current Procedures Terminology (CPT) codes. International Classification of Diseases Ninth Revision (ICD-9), Tenth (ICD-10) codes and CPT codes were used to identify patients requiring treatment for infection. All patients had at least 180 days of insurance coverage after intervention.
RESULTS
A total of 44,501 individuals aged below 18 years old and 63,495 individuals aged 18 to 30 years old that underwent arthroscopic ACL reconstruction were identified. There were no differences in infection rates between those below 18 years old (0.52%) and those above 18 years old (0.46%, P=0.227). However, among patients below 18 years old, patients below 15 years old had a significantly lower rate of infection at 0.37% compared with adolescents (15 to 17 y old) at 0.55% (P=0.039). Among young adults, males had higher rates of infection than females (0.52% vs. 0.37%), while no difference was observed in the pediatric and adolescent population (0.58% vs. 0.47%, P=0.109).
CONCLUSION
Utilizing an insurance database, this study demonstrated that rates of infection after ACL Reconstruction in a pediatric/adolescent population are low (0.52%) and similar to rates in young adults. Infection rates after ACLR reconstruction appear to be slightly lower in patients under 15 years of age (0.37%).
LEVEL OF EVIDENCE
Level III-Retrospective comparative study.
背景
许多研究表明，在儿科患者中进行前交叉韧带（ACL）重建手术的数量有所增加。尽管如此，大多数关于这些手术后手术部位感染率的知识都是基于成人研究得出的，目前在儿科患者中的数据有限。本研究的目的是利用 Truven Health Analytics MarketScan 商业索赔和就诊数据库描述和分析儿科和青少年（与年轻成年患者相比）患者 ACL 重建后的感染率。
方法
评估 Truven Health Analytics MarketScan 商业索赔和就诊数据库，以获取年龄在 5 至 30 岁之间的私人保险个人的医疗保健使用数据。使用当前程序术语（CPT）代码确定 2006 年至 2018 年期间进行的 ACL 重建记录。国际疾病分类第九版（ICD-9）、第十版（ICD-10）代码和 CPT 代码用于识别需要治疗感染的患者。所有患者在干预后至少有 180 天的保险覆盖。
结果
共确定了 44501 名年龄在 18 岁以下的人和 63495 名年龄在 18 至 30 岁之间的接受关节镜 ACL 重建的人。18 岁以下人群（0.52%）与 18 岁以上人群（0.46%，P=0.227）的感染率无差异。然而，在 18 岁以下的患者中，与青少年（15 至 17 岁）相比，15 岁以下的患者感染率明显较低，为 0.37%（P=0.039）。在年轻成年人中，男性的感染率高于女性（0.52%比 0.37%），而在儿科和青少年人群中则没有差异（0.58%比 0.47%，P=0.109）。
结论
利用保险数据库，本研究表明，儿科/青少年人群 ACL 重建后的感染率较低（0.52%），与年轻成年人相似。在 15 岁以下的患者中，ACLR 重建后的感染率似乎略低（0.37%）。
证据水平
三级-回顾性比较研究。
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