Department of Orthopaedic Surgery, Busan Mirae Hospital, Busan, Korea.
Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
J Korean Med Sci. 2024 Mar 25;39(11):e106. doi: 10.3346/jkms.2024.39.e106.
This study aimed to analyze the life expectancy and cause of death in osteoarthritis (OA) patients who underwent total knee arthroplasty (TKA) and to identify risk factors that affect long-term mortality rate after TKA.
Among 601 patients, who underwent primary TKA due to OA by a single surgeon from July 2005 to December 2011, we identified patients who died after the operation using data obtained from the National Statistical Office of Korea. We calculated 5-, 10-, and 15-year survival rates of the patients and age-specific standardized mortality ratios (SMRs) compared to general population of South Korea according to the causes of death. We also identified risk factors for death.
The 5-year, 10-year, and 15-year survival rates were 94%, 84%, and 75%, respectively. The overall age-specific SMR of the TKA cohort was lower than that of the general population (0.69; < 0.001). Cause-specific SMRs for circulatory diseases, neoplasms, and digestive diseases after TKA were significantly lower than those of the general population (0.65, 0.58, and 0.16, respectively; all < 0.05). Male gender, older age, lower body mass index (BMI), anemia, and higher Charlson comorbidity index (CCI) were significant factors associated with higher mortality after TKA.
TKA is a worthwhile surgery that can improve life expectancy, especially from diseases of the circulatory system, neoplasms, and digestive system, in patients with OA compared to the general population. However, careful follow-up is needed for patients with male gender, older age, lower BMI, anemia, and higher CCI, as these factors may increase long-term mortality risk after TKA.
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本研究旨在分析接受全膝关节置换术（TKA）的骨关节炎（OA）患者的预期寿命和死亡原因，并确定影响 TKA 后长期死亡率的危险因素。
在 2005 年 7 月至 2011 年 12 月期间，由一位外科医生对 601 名因 OA 接受初次 TKA 的患者进行了研究，我们使用从韩国国家统计局获得的数据，确定了手术后死亡的患者。我们根据死亡原因计算了患者的 5 年、10 年和 15 年生存率以及与韩国普通人群相比的年龄特异性标准化死亡率（SMR）。我们还确定了死亡的危险因素。
5 年、10 年和 15 年的生存率分别为 94%、84%和 75%。TKA 队列的总体年龄特异性 SMR 低于普通人群（0.69；<0.001）。TKA 后循环系统疾病、肿瘤和消化系统疾病的特定原因 SMR 明显低于普通人群（0.65、0.58 和 0.16，均<0.05）。男性、年龄较大、较低的体重指数（BMI）、贫血和较高的 Charlson 合并症指数（CCI）是 TKA 后死亡率较高的显著相关因素。
与普通人群相比，TKA 是一种有价值的手术，可以提高 OA 患者的预期寿命，特别是在循环系统疾病、肿瘤和消化系统疾病方面。然而，对于男性、年龄较大、较低的 BMI、贫血和较高的 CCI 的患者，需要进行仔细的随访，因为这些因素可能会增加 TKA 后长期死亡风险。
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