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接受全髋关节置换术的极年轻患者的特征:当代评估

Characteristics of Very Young Patients Undergoing Total Hip Arthroplasty: A Contemporary Assessment.

作者信息

Wang Jennifer C, Liu Kevin C, Gettleman Brandon S, Chen Matthew, Piple Amit S, Yang Jaewon, Heckmann Nathanael D, Christ Alexander B

机构信息

Keck School of Medicine of University of Southern California, Los Angeles, CA, USA.

University of South Carolina School of Medicine, Columbia, SC, USA.

出版信息

Arthroplast Today. 2023 Dec 28;25:101268. doi: 10.1016/j.artd.2023.101268. eCollection 2024 Feb.

Abstract

BACKGROUND

This study aims to compare indications, patient characteristics, hospital factors, and complication rates between total hip arthroplasty (THA) patients aged 30 years or younger and those older than 30 years using a large national database.

METHODS

The Premier Healthcare Database was utilized to identify primary THA patients from 2015 to 2021 who were aged ≤30 or >30 years. Patient demographics, hospital factors, and primary indications were compared for each cohort. Rates of complications and readmissions were assessed for each cohort by primary indication. Differences were assessed through univariate analysis.

RESULTS

Overall, 539,173 primary THA patients were identified (age ≤30: 1849; >30: 537,234). Compared to the >30 cohort, the ≤30 cohort was more likely to be male (56.5% vs 44.9%, < .001) and non-White (34.0% vs 14.2%, < .001). The most common indications for THA in the ≤30 cohort were osteonecrosis (49.3%), osteoarthritis (17.8%), and congenital hip deformities (16.0%), and in the >30 cohort, they were osteoarthritis (77.0%), other arthritis (11.3%), and osteonecrosis (5.4%). Patients aged ≤30 years had lower rates of respiratory failure (0.16% vs 0.57%, < .001), acute renal failure (0.32% vs 1.72%, < .001), and urinary tract infection (0.38% vs 1.11%,  = .003) than those aged >30 years, but higher rates of wound dehiscence (0.59% vs 0.29%,  = .015) and transfusion (3.68% vs 2.21%, < .001). There were no differences in 90-day readmission rates ( = .811) or 90-day in-hospital death ( = .173) between cohorts.

CONCLUSIONS

Younger patients undergoing THA differed significantly in indication, patient characteristics, and hospital factors compared to the older population on univariate analysis. Despite differences in indications, the cohorts did not differ markedly with regard to complication rates in this study.

摘要

背景

本研究旨在使用一个大型国家数据库,比较30岁及以下和30岁以上全髋关节置换术(THA)患者的手术指征、患者特征、医院因素及并发症发生率。

方法

利用Premier医疗数据库识别2015年至2021年年龄≤30岁或>30岁的初次THA患者。比较每个队列的患者人口统计学、医院因素和主要手术指征。按主要手术指征评估每个队列的并发症和再入院率。通过单因素分析评估差异。

结果

总体而言,共识别出539,173例初次THA患者(年龄≤30岁:1849例;>30岁:537,234例)。与>30岁队列相比,≤30岁队列男性比例更高(56.5%对44.9%,P<.001),非白人比例更高(34.0%对14.2%,P<.001)。≤30岁队列中THA最常见的手术指征是骨坏死(49.3%)、骨关节炎(17.8%)和先天性髋关节畸形(16.0%),>30岁队列中则是骨关节炎(77.0%)、其他关节炎(11.3%)和骨坏死(5.4%)。≤30岁的患者呼吸衰竭发生率(0.16%对0.57%,P<.001)、急性肾衰竭发生率(0.32%对1.72%,P<.001)和尿路感染发生率(0.38%对1.11%,P=.003)低于>30岁的患者,但伤口裂开发生率(0.59%对0.29%,P=.015)和输血率(3.68%对2.21%,P<.001)更高。队列间90天再入院率(P=.811)或90天住院死亡率(P=.173)无差异。

结论

单因素分析显示,与老年人群相比,接受THA的年轻患者在手术指征、患者特征和医院因素方面存在显著差异。尽管手术指征不同,但本研究中各队列在并发症发生率方面无明显差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4c22/10792167/9964bde95603/gr1.jpg

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