Cheng Chongjie, Yan Yan, Zhang Qidong, Guo Wanshou
Graduate School of Peking Union Medical College, Beijing, China.
China-Japan Friendship Institute of Clinical Medicine, Beijing, China.
Arthroplasty. 2021 Jul 2;3(1):21. doi: 10.1186/s42836-021-00078-4.
The purpose of this meta-analysis was to review the current evidence in the literature to find out whether the coexisting chronic kidney disease affected infection, revision, transfusion, readmission, mortality, and the length of hospital stay after total knee arthroplasty.
Medline, PubMed, Embase, and the Cochrane Library were searched from their dates of inception to June 30, 2020. The primary outcomes were postoperative infection, revision, and mortality. The secondary outcomes were transfusion, the length of hospital stay, and readmission. A P value of < 0.05 was deemed to be statistically significant.
A total of 881 articles were identified, and 7 articles that met the inclusion criteria were identified to be eligible. The most important finding of our study was that the chronic kidney disease was associated with increased postoperative transfusion (P < 0.05) and mortality (P < 0.05). Meanwhile, the patients with chronic kidney disease were associated with a higher readmission rate, compared to the patients without chronic kidney disease (P < 0.05). However, chronic kidney disease was not associated with high risks for infection (P > 0.05), revision surgeries (P > 0.05), and a prolonged hospital stay (P > 0.05).
After total knee arthroplasty, the patients with coexisting chronic kidney disease carry higher risks of transfusion, mortality, and readmission. However, the chronic kidney disease may not be associated with the risk of infection or revision, nor the duration of hospitalization.
本荟萃分析的目的是回顾文献中的现有证据，以确定并存的慢性肾脏病是否会影响全膝关节置换术后的感染、翻修、输血、再入院、死亡率及住院时间。
检索了Medline、PubMed、Embase和Cochrane图书馆，检索时间从建库至2020年6月30日。主要结局为术后感染、翻修和死亡率。次要结局为输血、住院时间和再入院。P值<0.05被认为具有统计学意义。
共识别出881篇文章，其中7篇符合纳入标准的文章被确定为合格。我们研究的最重要发现是，慢性肾脏病与术后输血增加（P<0.05）和死亡率增加（P<0.05）相关。同时，与无慢性肾脏病的患者相比，慢性肾脏病患者的再入院率更高（P<0.05）。然而，慢性肾脏病与感染高风险（P>0.05）、翻修手术（P>0.05）及住院时间延长（P>0.05）无关。
全膝关节置换术后，并存慢性肾脏病的患者输血、死亡和再入院风险更高。然而，慢性肾脏病可能与感染或翻修风险无关，也与住院时间无关。
