九十岁以上患者初次和翻修全髋关节置换术后的院内转归。
In-hospital outcomes following primary and revision total hip arthroplasty in nonagenarian patients.
作者信息
Kucukkarapinar Ibrahim, Gozacan Beren, Ekhtiari Seper, Dasci Mustafa Fatih, Gehrke Thorsten, Citak Mustafa
机构信息
Department of Orthopaedic Surgery, HELIOS ENDO-Klinik Hamburg, Holstenstr. 2, 22767, Hamburg, Germany.
Department of Orthopaedics and Traumatology, Istanbul Bagcilar Training and Research Hospital, Istanbul, Turkey.
出版信息
Arch Orthop Trauma Surg. 2024 Jan;144(1):475-481. doi: 10.1007/s00402-023-05032-4. Epub 2023 Aug 27.
PURPOSE
The primary goal of this study was to assess the risk of postoperative surgical and medical complications and problems among nonagenarian patients operated with hip arthroplasty.
METHODS
Data from a specific high-volume arthroplasty clinic, were collected to evaluate postoperative morbidity and complication rates after hip arthroplasty in nonagenarians, compared with a control group of younger, but similar patients. Outcomes evaluated included length of stay, transfusion rate, and postoperative medical and surgical complication rates.
RESULTS
A total of 97 nonagenarian patients (mean age 91.4 years) were included, and compared with 89 control group patients (mean age 70.18 years). Nonagenarian patients had significantly longer length of stay (11.44 vs. 7.98 days, p < 0.01), significantly higher risk of needing a transfusion (11.30% vs. 3.40%, p = 0.04), and significantly higher risk of a postoperative medical complication (28.90% vs. 11.20%, p = 0.03). There was no difference in postoperative surgical complication rate (7.20% vs. 2.20%, p = 0.12).
CONCLUSION
Nonagenarian patients, when compared to a younger control group, experience significantly longer hospital stays, and risk of non-surgical complications. Arthroplasty in nonagenarian patients carries with it a high risk of complications, and thus careful pre-operative evaluation and the care of these patients at high volume, specialized clinics is important to optimize outcomes.
LEVEL OF EVIDENCE
Level III retrospective cohort analysis.
目的
本研究的主要目的是评估行髋关节置换术的 90 岁以上患者术后手术和医疗并发症及问题的风险。
方法
从一个特定的大容量关节置换诊所收集数据，以评估 90 岁以上患者髋关节置换术后的发病率和并发症发生率，并与年龄较小但相似的对照组进行比较。评估的结果包括住院时间、输血率以及术后医疗和手术并发症发生率。
结果
共纳入 97 例 90 岁以上患者（平均年龄 91.4 岁），并与 89 例对照组患者（平均年龄 70.18 岁）进行比较。90 岁以上患者的住院时间明显延长（11.44 天比 7.98 天，p<0.01），需要输血的风险明显更高（11.30%比 3.40%，p=0.04），术后发生医疗并发症的风险明显更高（28.90%比 11.20%，p=0.03）。术后手术并发症发生率无差异（7.20%比 2.20%，p=0.12）。
结论
与年轻对照组相比，90 岁以上患者的住院时间明显延长，且非手术并发症的风险更高。90 岁以上患者行关节置换术并发症风险较高，因此，术前仔细评估和在高容量、专业诊所对这些患者进行护理，对于优化结果非常重要。
证据等级
III 级回顾性队列分析。
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