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重新思考风险预测:白蛋白和其他参数在髋关节或膝关节置换术后与植入物相关并发症中的作用。

Rethinking risk prediction: The role of albumin and other parameters in implant-associated complications after hip or knee arthroplasty.

机构信息

Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Kralove, Charles University, Prague, Czech Republic.

Department of Clinical Biochemistry and Diagnostics and Osteocenter, University Hospital Hradec Kralove, Hradec Králové, Czech Republic.

出版信息

PLoS One. 2024 Jul 29;19(7):e0306468. doi: 10.1371/journal.pone.0306468. eCollection 2024.

Abstract

BACKGROUND

Total hip (THA) or knee (TKA) arthroplasty is still a traumatic and challenging operation that induces inflammation, with a particularly high risk of acute-phase reaction. The aim of this study was to predict the likelihood of implant-associated complications during the preoperative and postoperative course.

METHODS

The prospective observational, non-interventional study of patients diagnosed with primary knee or hip osteoarthrosis undergoing THA or TKA during the study period was conducted. The inflammatory and malnutrition parameters were collected for each patient one day before surgery, two days after surgery, and in outpatient follow-up.

RESULTS

Of 159 patients analysed, 12 developed implant-associated complications. The albumin, prealbumin, Intensive Care Infection Score (ICIS), Nutritional Risk Index, and white blood cell counts were found to be potential predictors. Notably, preoperative albumin levels significantly differed between groups with and without complications (P-value = 0.042).

CONCLUSION

Our study definitively shows that WBC, prealbumin, Nutritional Risk Index, ICIS as a novel marker, and significantly albumin, outperform C-reactive protein in predicting implant-associated complications in hip and knee arthroplasty.

摘要

背景

全髋关节(THA)或全膝关节(TKA)置换术仍然是一种创伤性和具有挑战性的手术,会引起炎症,急性期反应的风险特别高。本研究旨在预测术前和术后期间与植入物相关并发症的可能性。

方法

对在研究期间接受初次膝关节或髋关节骨关节炎 THA 或 TKA 治疗的患者进行前瞻性观察性、非干预性研究。在术前一天、术后两天和门诊随访时收集每位患者的炎症和营养不良参数。

结果

在分析的 159 名患者中,有 12 名发生了与植入物相关的并发症。白蛋白、前白蛋白、重症监护感染评分(ICIS)、营养风险指数和白细胞计数被认为是潜在的预测因子。值得注意的是,有并发症和无并发症组之间的术前白蛋白水平存在显著差异(P 值=0.042)。

结论

我们的研究明确表明,WBC、前白蛋白、营养风险指数、ICIS 作为一种新型标志物,以及显著的白蛋白,在预测髋关节和膝关节置换术与植入物相关并发症方面优于 C-反应蛋白。

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