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门诊与住院单髁膝关节置换术的安全性评估:系统评价和荟萃分析。

Safety evaluation of outpatient vs inpatient unicompartmental knee arthroplasty: a systematic review and meta-analysis.

机构信息

Department of Sports Medicine and Arthroscopy, Tianjin Hospital of Tianjin University, Tianjin, China.

出版信息

Arch Orthop Trauma Surg. 2024 Aug;144(8):3615-3624. doi: 10.1007/s00402-024-05446-8. Epub 2024 Jul 13.

DOI:10.1007/s00402-024-05446-8
PMID:39002050
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11417048/
Abstract

PURPOSE

This systematic review and meta-analysis aimed to evaluate the safety of outpatient and inpatient Unicompartmental Knee Arthroplasty (UKA) based on the incidence of adverse events.

METHOD

A systematic search of the literature was performed in October 2022 on PubMed, Web of Science, Cochrane library, and Embase. The Meta package for R was used to perform the meta-analysis.

RESULT

Five studies with a total of 26,301 patients were included. 5813 patients (22.1%) were treated with outpatient UKA, and 20,488 patients (77.9%) were treated with inpatient UKA. There were no statistically significant differences in the incidence of total complications (RR = 1.36, 95% CI = 0.64-2.89, Z = 0.79, P = 0.43), readmission (RR = 1.02, 95% CI = 0.40-2.60, Z = 0.05, P = 0.96), and venous thrombosis (RR = 1.43, 95% CI = 0.96-2.11, Z = 1.78, P = 0.08). Incidence rates were lower in outpatient UKA regarding urinary tract infection (RR = 1.48, 95% CI = 1.07-2.04, Z = 2.40, P = 0.02), pulmonary embolus (RR = 7.48, 95% CI = 1.80-31.17, Z = 2.76, P < 0.01), and transfusion (RR = 2.77, 95% CI = 1.63-4.71, Z = 3.78, P < 0.01).

CONCLUSION

In summary, outpatient UKA shows lower incidences of hospital-acquired complications such urinary tract infection, pulmonary embolus, and transfusion. It's worth noting that the incidences of total complications, readmission, and venous thrombosis in outpatient UKA were not higher than the incidences of inpatient UKA, suggestting that outpatient UKA can be considered a safe alternative to inpatient UKA.

摘要

目的

本系统评价和荟萃分析旨在评估门诊和住院单髁膝关节置换术(UKA)的安全性,基于不良事件的发生率。

方法

2022 年 10 月,我们在 PubMed、Web of Science、Cochrane 图书馆和 Embase 上进行了系统的文献检索。使用 R 中的 Meta 程序包进行荟萃分析。

结果

共纳入 5 项研究,总计 26301 例患者。5813 例(22.1%)接受门诊 UKA 治疗,20488 例(77.9%)接受住院 UKA 治疗。总并发症发生率(RR=1.36,95%CI=0.64-2.89,Z=0.79,P=0.43)、再入院率(RR=1.02,95%CI=0.40-2.60,Z=0.05,P=0.96)和静脉血栓形成发生率(RR=1.43,95%CI=0.96-2.11,Z=1.78,P=0.08)无统计学差异。门诊 UKA 组尿路感染发生率(RR=1.48,95%CI=1.07-2.04,Z=2.40,P=0.02)、肺栓塞发生率(RR=7.48,95%CI=1.80-31.17,Z=2.76,P<0.01)和输血发生率(RR=2.77,95%CI=1.63-4.71,Z=3.78,P<0.01)较低。

结论

综上所述,门诊 UKA 术后医院获得性并发症(如尿路感染、肺栓塞和输血)发生率较低。值得注意的是,门诊 UKA 总并发症、再入院和静脉血栓形成的发生率并不高于住院 UKA,表明门诊 UKA 可作为住院 UKA 的一种安全替代方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92ac/11417048/21c153f0619a/402_2024_5446_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92ac/11417048/5adf3276b0ca/402_2024_5446_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92ac/11417048/21c153f0619a/402_2024_5446_Fig7_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92ac/11417048/5adf3276b0ca/402_2024_5446_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92ac/11417048/fa1be5f4694b/402_2024_5446_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/92ac/11417048/21c153f0619a/402_2024_5446_Fig7_HTML.jpg

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