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出血性疾病增加了关节镜下肩袖修复术后发生并发症的风险。

Bleeding disorder increases the risks of complications following arthroscopic rotator cuff repair.

机构信息

University of Missouri-Kansas City School of Medicine, Kansas City, MO, USA.

Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

出版信息

Eur J Orthop Surg Traumatol. 2024 Dec;34(8):3909-3915. doi: 10.1007/s00590-024-04073-8. Epub 2024 Aug 22.

Abstract

BACKGROUND

It is imperative to determine patients' risk factors prior to arthroscopic rotator cuff repair (ARCR), so that the physician and patient are both aware of the possible postoperative complications. However, the impact of bleeding disorders on a patient's short-term postoperative outcome has not yet been analyzed.

METHODS

A national database was queried for patients undergoing ARCR from 2006 to 2018. Two patient cohorts were defined: patients with a bleeding disorder and patients without a bleeding disorder. In this analysis, outcomes including postoperative complications, hospital admission, extended length of stay, and mortality were compared between the two cohorts using bivariate and multivariate analyses.

RESULTS

Of 33,374 patients undergoing ARCR, 32,849 patients (98.4%) did not have a bleeding disorder whereas 525 patients (1.6%) had a bleeding disorder. Following adjustment on multivariate analyses, patients with a bleeding disorder had an increased risk of postoperative transfusion (OR 8.11; p = 0.044), sepsis (OR 11.86; p = 0.003), hospital admission (OR 1.41; p = 0.008), and mortality (OR 8.10; p = 0.019).

CONCLUSIONS

Patients with documented bleeding disorder have an increased risk of postoperative complications compared to patients without a bleeding disorder. Consequently, it is essential to recognize these risk factors to decrease postoperative complications to optimize patient outcomes and costs.

LEVEL OF EVIDENCE

III.

摘要

背景

在进行关节镜肩袖修复术 (ARCR) 之前,确定患者的风险因素至关重要,以便医生和患者都能了解可能的术后并发症。然而,出血性疾病对患者短期术后结果的影响尚未得到分析。

方法

对 2006 年至 2018 年期间接受 ARCR 的患者进行了全国性数据库查询。定义了两组患者:有出血性疾病的患者和无出血性疾病的患者。在这项分析中,使用双变量和多变量分析比较了两组之间的术后并发症、住院、延长住院时间和死亡率等结果。

结果

在 33374 例接受 ARCR 的患者中,32849 例(98.4%)没有出血性疾病,而 525 例(1.6%)有出血性疾病。在多变量分析调整后,有出血性疾病的患者术后输血的风险增加(OR 8.11;p=0.044)、感染性并发症(OR 11.86;p=0.003)、住院(OR 1.41;p=0.008)和死亡率(OR 8.10;p=0.019)的风险增加。

结论

与无出血性疾病的患者相比,有出血性疾病记录的患者术后并发症风险增加。因此,必须认识到这些风险因素,以减少术后并发症,优化患者的预后和成本。

证据水平

III。

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