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人口统计学和手术相关并发症导致膝关节关节镜手术 30 天再入院率。

Demographics and surgery-related complications lead to 30-day readmission rates among knee arthroscopic procedures.

机构信息

Department of Health Administration, Brooks College of Health, University of North Florida, 1 UNF Drive, Jacksonville, FL, 32224-2646, USA.

Department of Public Administration, School of Criminology, Criminal Justice and Public Administration, College of Liberal and Fine Arts, Tarleton State University, 10850 Texan Rider Dr., Rm # 336, Fort Worth, TX, 76036-9414, USA.

出版信息

Knee Surg Sports Traumatol Arthrosc. 2022 Jul;30(7):2408-2418. doi: 10.1007/s00167-022-06919-2. Epub 2022 Feb 23.

Abstract

PURPOSE

The study objectives were (1) to evaluate risk factors related to 30-day hospital readmissions after arthroscopic knee surgeries and (2) to determine the complications that may arise from surgery.

METHODS

The American College of Surgeons National Surgical Quality Improvement Program database data from 2012 to 2017 were researched. Patients were identified using Current Procedural Terminology codes for knee arthroscopic procedures. Ordinal logistic fit regression and decision tree analysis were used to examine study objectives.

RESULTS

There were 83,083 knee arthroscopic procedures between 2012 and 2017 obtained from the National Surgical Quality Improvement Program database. The overall readmission rate was 0.87%. The complication rates were highest for synovectomy and cartilage procedures, 1.6% and 1.3% respectively. A majority of readmissions were related to the procedure (71.1%) with wound complications being the primary reason (28.2%) followed by pulmonary embolism and deep vein thrombosis, 12.7% and 10.6%, respectively. Gender and body mass index were not significant factors and age over 65 years was an independent risk factor. Wound infection, deep vein thrombosis, and pulmonary embolism were the most prevalent complications.

CONCLUSION

Healthcare professionals have a unique opportunity to modify treatment plans based on patient risk factors. For patients who are at higher risk of inferior surgical outcomes, clinicians should carefully weigh risk factors when considering surgical and non-surgical approaches.

LEVEL OF EVIDENCE

III.

摘要

目的

本研究的目的为(1)评估关节镜膝关节手术后 30 天内住院再入院的相关风险因素,(2)确定手术可能产生的并发症。

方法

研究使用了 2012 年至 2017 年美国外科医师学院国家外科质量改进计划数据库的数据。患者通过膝关节关节镜手术的当前操作术语代码进行识别。使用有序逻辑拟合回归和决策树分析来检查研究目标。

结果

从国家外科质量改进计划数据库中获得了 2012 年至 2017 年间 83083 例膝关节关节镜手术。总体再入院率为 0.87%。滑膜切除术和软骨手术的并发症发生率最高,分别为 1.6%和 1.3%。大多数再入院与手术有关(71.1%),其中伤口并发症是主要原因(28.2%),其次是肺栓塞和深静脉血栓形成,分别为 12.7%和 10.6%。性别和体重指数不是显著因素,65 岁以上年龄是独立的危险因素。伤口感染、深静脉血栓形成和肺栓塞是最常见的并发症。

结论

医疗保健专业人员有机会根据患者的风险因素修改治疗计划。对于手术结果较差风险较高的患者,临床医生在考虑手术和非手术方法时应仔细权衡风险因素。

证据水平

III。

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