School of Health, Dongguan Polytechnic, Dongguan, Guangdong, 523000, China.
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, 510515, China.
J Orthop Surg Res. 2024 Jun 14;19(1):353. doi: 10.1186/s13018-024-04836-3.
Postoperative pulmonary complications (PPCs) are among the most severe complications following total hip arthroplasty revision (THAR), imposing significant burdens on individuals and society. This study examined the prevalence and risk factors of PPCs following THAR using the NIS database, identifying specific pulmonary complications (SPCs) and their associated risks, including pneumonia, acute respiratory failure (ARF), and pulmonary embolism (PE).
The National Inpatient Sample (NIS) database was used for this cross-sectional study. The analysis included patients undergoing THAR based on NIS from 2010 to 2019. Available data include demographic data, diagnostic and procedure codes, total charges, length of stay (LOS), hospital information, insurance information, and discharges.
From the NIS database, a total of 112,735 THAR patients in total were extracted. After THAR surgery, there was a 2.62% overall incidence of PPCs. Patients with PPCs after THAR demonstrated increased LOS, total charges, usage of Medicare, and in-hospital mortality. The following variables have been determined as potential risk factors for PPCs: advanced age, pulmonary circulation disorders, fluid and electrolyte disorders, weight loss, congestive heart failure, metastatic cancer, other neurological disorders (encephalopathy, cerebral edema, multiple sclerosis etc.), coagulopathy, paralysis, chronic pulmonary disease, renal failure, acute heart failure, deep vein thrombosis, acute myocardial infarction, peripheral vascular disease, stroke, continuous trauma ventilation, cardiac arrest, blood transfusion, dislocation of joint, and hemorrhage.
Our study revealed a 2.62% incidence of PPCs, with pneumonia, ARF, and PE accounting for 1.24%, 1.31%, and 0.41%, respectively. A multitude of risk factors for PPCs were identified, underscoring the importance of preoperative optimization to mitigate PPCs and enhance postoperative outcomes.
术后肺部并发症（PPCs）是全髋关节置换翻修术（THAR）后最严重的并发症之一，给个人和社会带来了巨大负担。本研究使用国家住院患者样本（NIS）数据库研究了 THAR 术后 PPCs 的患病率和危险因素，确定了具体的肺部并发症（SPCs）及其相关风险，包括肺炎、急性呼吸衰竭（ARF）和肺栓塞（PE）。
本横断面研究使用国家住院患者样本（NIS）数据库。该分析包括根据 NIS 从 2010 年至 2019 年接受 THAR 的患者。可用数据包括人口统计学数据、诊断和程序代码、总费用、住院时间（LOS）、医院信息、保险信息和出院情况。
从 NIS 数据库中提取了总共 112735 例 THAR 患者。THAR 手术后，PPCs 的总体发生率为 2.62%。THAR 术后发生 PPCs 的患者 LOS、总费用、使用医疗保险和住院死亡率增加。以下变量已确定为 PPCs 的潜在危险因素：年龄较大、肺循环障碍、液体和电解质紊乱、体重减轻、充血性心力衰竭、转移性癌症、其他神经系统疾病（脑病、脑水肿、多发性硬化症等）、凝血障碍、瘫痪、慢性肺部疾病、肾衰竭、急性心力衰竭、深静脉血栓形成、急性心肌梗死、周围血管疾病、中风、持续创伤通气、心脏骤停、输血、关节脱位和出血。
我们的研究显示 PPCs 的发生率为 2.62%，其中肺炎、ARF 和 PE 分别占 1.24%、1.31%和 0.41%。确定了 PPCs 的多种危险因素，强调了术前优化的重要性，以减轻 PPCs 并改善术后结局。
