Department of Orthopedic Surgery, Aalborg University Hospital, Hobrovej 18-22, 9000, Aalborg, Denmark.
Lundbeck Foundation Centre for Fast-track Hip and Knee Arthroplasty, Copenhagen, Denmark.
Arch Orthop Trauma Surg. 2023 Oct;143(10):6033-6038. doi: 10.1007/s00402-023-04887-x. Epub 2023 Apr 26.
Gastrointestinal complications after total hip (THA) and knee arthroplasty (TKA) have been reported to be between 0.3 and 2.6% with bleeding and C. difficile infection in 0-1%, and 0.1-1.7%, respectively. The use of enhanced recovery or "fast-track" protocols have focused on optimizing all aspects of perioperative care resulting in reduced length of hospital stay (LOS) and potentially also gastrointestinal complications. This study is a detailed analysis on the occurrence of postoperative gastrointestinal complications resulting in increased hospital stay or readmissions in a large consecutive cohort of fast-track THA and TKA with complete 90 days follow-up.
This is an observational study on a consecutive cohort of primary unilateral THAs and TKAs performed between January 2010 and August 2017 in nine Danish high-volume fast-track centers. Discharge summaries and relevant patient records were reviewed in patients with readmissions within 90 days or LOS > 4 days caused by gastrointestinal complications.
The cohort included 36,932 patients with 58.3% females and 54.1% THAs. Mean age and BMI were 68 years and 28. Median postoperative LOS was 2 days. Only n: 276 (0.75 %) had a LOS > 4 days or a readmission within 90 days due to a gastrointestinal complication (CI 0.67%-0.84%). Of these, only 34 (0.09%) were graded as severe ileus or gastrointestinal bleeding.
The risk of GI-complications within the first 90 postoperative days after fast-track THA and TKA was low (0.75%).
全髋关节置换术（THA）和全膝关节置换术（TKA）后胃肠道并发症的发生率为 0.3%至 2.6%，出血和艰难梭菌感染的发生率分别为 0-1%和 0.1-1.7%。强化康复或“快速通道”方案的应用重点是优化围手术期的各个方面，从而缩短住院时间（LOS），并可能降低胃肠道并发症的发生率。本研究对 90 天内进行的大量连续快速通道 THA 和 TKA 队列中，因术后胃肠道并发症导致住院时间延长或再次入院的情况进行了详细分析，该队列有完整的 90 天随访。
这是一项观察性研究，纳入了 2010 年 1 月至 2017 年 8 月在丹麦 9 个大容量快速通道中心进行的单侧初次 THA 和 TKA 连续队列。对 90 天内再次入院或因胃肠道并发症导致 LOS>4 天的患者的出院小结和相关病历进行了回顾。
队列纳入了 36932 例患者，其中 58.3%为女性，54.1%为 THA。平均年龄和 BMI 分别为 68 岁和 28. 术后 LOS 的中位数为 2 天。只有 n：276（0.75%）因胃肠道并发症（CI 0.67%-0.84%）而导致 LOS>4 天或 90 天内再次入院。其中只有 34 例（0.09%）被评为严重肠梗阻或胃肠道出血。
快速通道 THA 和 TKA 后 90 天内胃肠道并发症的风险较低（0.75%）。
