全髋关节置换术的法定盲人患者围手术期并发症——一项全国住院患者样本数据库研究。
Perioperative complications of legally blind patients undergoing total hip arthroplasty - A national in-patient sample database study.
作者信息
Venishetty Nikit, Sohn Garrett, Nguyen Ivy, Trivedi Meesha, Mounasamy Varatharaj, Sambandam Senthil
机构信息
Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 5001 El Paso Dr, El Paso, TX, USA.
University of Texas Southwestern, 5323 Harry Hines Blvd, Dallas, TX, USA.
出版信息
J Orthop. 2023 Apr 24;40:47-51. doi: 10.1016/j.jor.2023.04.019. eCollection 2023 Jun.
BACKGROUND
Legally blind patients are more prone to injury-related falls, which may lead to hip fractures, often necessitating total hip arthroplasty (THA), as a corrective procedure. Many of these patients have unique medical needs and have increased rates of perioperative complications following surgical procedures. However, there is limited information on the hospitalization data and perioperative complications in this population following guidelines such as THA. The purpose of this study was to evaluate the patient characteristics, demographics, and prevalence of perioperative issues among THA patients who were legally blind.
METHODS
Using 2016-2019 data from the Nationwide Inpatient Sample (NIS), the incidence of perioperative complications, length of stay (LOS), and the cost of care (COC) among patients undergoing THA who were categorized as legally blind patients, compared to those who were not were analyzed. Propensity matching was conducted to consider associated factors that may influence perioperative complications.
RESULTS
From 2016 to 2019, 367,856 patients underwent THA, according to the NIS. Of those, 322 (0.1%) patients were categorized as legally blind, and the remaining 367,534 (99.9%) patients were not identified as legally blind (control). Legally blind patients were significantly younger than the control group (65.4 years vs. 66.7 years, p < 0.001). After propensity matching, legally blind patients had longer LOS (3.9 days vs. 2.8, p = 0.04), increased discharges to another facility (45.9% vs. 29.3%, p < 0.001), and fewer discharges to home (21.4% vs. 32.2%, p = 0.02) than control patients.
CONCLUSIONS
The legally blind group had significantly longer LOS, higher rates of discharge to another facility, and lower rates of discharge to home compared to the control group. This data will help providers make informed decisions about patient care and resource allocation for legally blind patients undergoing THA.
背景
法定失明患者更容易因受伤而跌倒，这可能导致髋部骨折，通常需要进行全髋关节置换术（THA）作为矫正手术。这些患者中的许多人有独特的医疗需求，并且手术后围手术期并发症的发生率增加。然而，关于遵循THA等指南的这一人群的住院数据和围手术期并发症的信息有限。本研究的目的是评估法定失明的THA患者的患者特征、人口统计学和围手术期问题的发生率。
方法
使用来自全国住院患者样本（NIS）的2016 - 2019年数据，分析了被归类为法定失明患者的THA患者与未被归类为法定失明患者的围手术期并发症发生率、住院时间（LOS）和护理费用（COC）。进行倾向匹配以考虑可能影响围手术期并发症的相关因素。
结果
根据NIS，2016年至2019年期间，有367,856例患者接受了THA。其中，322例（0.1%）患者被归类为法定失明，其余367,534例（99.9%）患者未被识别为法定失明（对照组）。法定失明患者明显比对照组年轻（65.4岁对66.7岁，p < 0.001）。倾向匹配后，法定失明患者的住院时间更长（3.9天对
2.8天，p = 0.04），转至另一机构的出院率更高（45.9%对29.3%，p < 0.001），出院回家的比例更低（21.4%对32.2%，p = 0.02）。
结论
与对照组相比，法定失明组的住院时间明显更长，转至另一机构的出院率更高，出院回家的比例更低。这些数据将有助于医疗服务提供者为接受THA的法定失明患者的护理和资源分配做出明智的决策。
Zotero 插件