Robertson Fabienne M, Clement Nicholas D
Department of Orthopaedics and Trauma, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom.
J Arthroplasty. 2023 Jan;38(1):51-59. doi: 10.1016/j.arth.2022.07.010. Epub 2022 Jul 31.
The primary aim assessed whether preoperative anemia was associated with a worse knee-specific functional outcome after total knee arthroplasty (TKA). The secondary aims assessed the association of preoperative anemia with generic health and patient satisfaction.
A retrospective cohort study was undertaken to compare patients who did and did not have anemia (Hb <13.0 g/dL for men and Hb <11.5 g/dL for women). During a 1-year period, 497 patients underwent a total knee arthroplasty with complete preoperative and postoperative data, including 215 (43.3%) men and 282 (56.7%) women, who had a mean age of 70 years (range 45-93). Patient demographics, comorbidities, preoperative and postoperative (1 year) Oxford Knee Score (OKS), EuroQol 5 dimension (EQ-5D), postoperative Forgotten Joint Score (FJS), and patient satisfaction were collected. Regression analyses were used to adjust for confounding factors between the groups.
The 56 (11.3%) patients who had anemia were older (4.6 years, P < .001) and more likely to have chronic obstructive pulmonary disease (P = .004), connective tissue (P = .047), or kidney disease (P = .011) compared to those who did not have anemia. There were no differences in the preoperative OKS (P = .752) or EQ-5D (P = .762) scores between the groups. When adjusting for confounding differences, there was a significantly lower postoperative OKS (-3.0 points, P = .035) and FJS (-11.6 points, P = .011) associated with the anemia group. There were no significant differences in the EQ-5D (P = .118) or patient satisfaction between groups (odds ratio 0.84, P = .976).
Preoperative anemia is associated with a lower postoperative joint-specific functional outcome. It is not clear if these differences are clinically meaningful. No difference in patient satisfaction was observed.
Level III, diagnostic study.
主要目的是评估术前贫血是否与全膝关节置换术（TKA）后膝关节特定功能预后较差相关。次要目的是评估术前贫血与一般健康状况和患者满意度之间的关联。
进行一项回顾性队列研究，比较有贫血（男性血红蛋白<13.0 g/dL，女性血红蛋白<11.5 g/dL）和无贫血的患者。在1年期间，497例患者接受了全膝关节置换术，他们有完整的术前和术后数据，其中包括215例（43.3%）男性和282例（56.7%）女性，平均年龄为70岁（范围45 - 93岁）。收集患者的人口统计学资料、合并症、术前和术后（1年）牛津膝关节评分（OKS）、欧洲五维健康量表（EQ - 5D）、术后遗忘关节评分（FJS）以及患者满意度。采用回归分析来调整组间的混杂因素。
与无贫血患者相比，56例（11.3%）有贫血的患者年龄更大（4.6岁，P <.001），更有可能患有慢性阻塞性肺疾病（P =.004）、结缔组织病（P =.047）或肾病（P =.011）。两组术前OKS评分（P =.752）或EQ - 5D评分（P =.762）无差异。在调整混杂差异后，贫血组术后OKS评分显著更低（-3.0分，P =.035），FJS评分显著更低（-11.6分，P =.011）。两组在EQ - 5D评分（P =.118）或患者满意度方面无显著差异（优势比0.84，P =.976）。
术前贫血与术后关节特定功能预后较低相关。尚不清楚这些差异是否具有临床意义。未观察到患者满意度存在差异。
三级，诊断性研究。
