Department of Orthopaedic Surgery, UT Southwestern Medical Center, Dallas, TX, USA.
UT Southwestern Medical Center at Frisco, 12500 Dallas Parkway, 3rd Floor, Orthopaedic Surgery, Frisco, TX, 75033-9071, USA.
Arch Orthop Trauma Surg. 2024 Dec;144(12):5061-5070. doi: 10.1007/s00402-023-05107-2. Epub 2023 Oct 30.
Several risk factors for revision TKA have previously been identified, but interactions between risk factors may occur and affect risk of revision. To our knowledge, such interactions have not been previously studied. As patients often exhibit multiple risk factors for revision, knowledge of these interactions can help improve risk stratification and patient education prior to TKA.
The State Inpatient Databases (SID), part of the Healthcare Cost and Utilization Project (HCUP), were queried to identify patients who underwent TKA between January 1, 2006 and December 31, 2015. Risk factors for revision TKA were identified, and interactions between indication for TKA and other risk factors were analyzed.
Of 958,944 patients who underwent TKA, 33,550 (3.5%) underwent revision. Age, sex, race, length of stay, Elixhauser readmission score, urban/rural designation, and indication for TKA were significantly associated with revision (p < 0.05). Age was the strongest predictor (p < 0.0001), with younger patients exhibiting higher revision risk. Risks associated with age were modified by an interaction with indication for TKA (p < 0.0001). There was no significant interaction between sex and indication for TKA (p = 0.535) or race and indication for TKA (p = 0.187).
Age, sex, race, length of stay, Elixhauser readmission score, urban/rural designation, and indication for TKA are significantly associated with revision TKA. Interaction occurs between age and indication.
先前已经确定了几种翻修 TKA 的风险因素，但风险因素之间可能存在相互作用并影响翻修风险。据我们所知，这些相互作用尚未被研究过。由于患者通常表现出多种翻修风险因素，因此了解这些相互作用可以帮助改善 TKA 之前的风险分层和患者教育。
查询了 Healthcare Cost and Utilization Project (HCUP) 的 State Inpatient Databases (SID)，以确定 2006 年 1 月 1 日至 2015 年 12 月 31 日期间接受 TKA 的患者。确定了翻修 TKA 的风险因素，并分析了 TKA 适应证与其他风险因素之间的相互作用。
在接受 TKA 的 958944 名患者中，有 33550 名（3.5%）接受了翻修。年龄、性别、种族、住院时间、Elixhauser 再入院评分、城乡指定和 TKA 适应证与翻修显著相关（p<0.05）。年龄是最强的预测因素（p<0.0001），年轻患者的翻修风险更高。与年龄相关的风险受 TKA 适应证相互作用的影响（p<0.0001）。性别和 TKA 适应证之间（p=0.535）或种族和 TKA 适应证之间（p=0.187）没有显著的相互作用。
年龄、性别、种族、住院时间、Elixhauser 再入院评分、城乡指定和 TKA 适应证与翻修 TKA 显著相关。年龄和适应证之间存在相互作用。
