Behcet 综合征患者全髋关节和全膝关节置换术后并发症风险。

Risk of Postoperative Complications After Total Hip and Total Knee Arthroplasty in Behcet Syndrome Patients.

机构信息

From the Department of Orthopedics and Rehabilitation, Yale School of Medicine, New Haven, CT.

出版信息

J Am Acad Orthop Surg Glob Res Rev. 2024 Oct 10;8(10). doi: 10.5435/JAAOSGlobal-D-24-00040. eCollection 2024 Oct 1.

DOI:10.5435/JAAOSGlobal-D-24-00040

PMID:39392934

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11469891/

Abstract

BACKGROUND

Behcet syndrome (BS), a multisystem autoimmune disorder, has unclear effects on outcomes after total hip arthroplasty (THA) and total knee arthroplasty (TKA). This study assessed the relative risk of perioperative adverse events in patients with BS.

METHODS

This retrospective cohort study used the PearlDiver M157Ortho data set, a large national administrative database. Total hip arthroplasty and TKA patients with BS were identified and matched 1:4 to those without BS based on patient age, sex, Elixhauser Comorbidity Index scores, and procedure performed (THA or TKA). The incidence of 90-day adverse events was determined and compared by multivariate analysis. 5-year survival to revision surgeries was assessed and compared with the log-rank test.

RESULTS

After matching, 282 THA/TKA patients with BS were identified and compared with 1127 without BS. On multivariate analysis, patients with BS were at independently greater risk of aggregated any (odds ratio [OR] 2.16, P < 0.0001), serious (OR 1.78, P = 0.0051), and minor (OR 2.39, P < 0.0001) adverse events compared with those without BS. No significant difference was observed in 5-year survival to revision surgery (P = 0.3).

CONCLUSIONS

Patients with BS undergoing THA or TKA experienced markedly greater 90-day postoperative adverse events. The findings underscore the need for optimized perioperative management for patients with BS undergoing arthroplasty.

摘要

背景

贝赫切特综合征（BS）是一种多系统自身免疫性疾病，对全髋关节置换术（THA）和全膝关节置换术（TKA）后的结果影响尚不清楚。本研究评估了 BS 患者围手术期不良事件的相对风险。

方法

本回顾性队列研究使用了 PearlDiver M157Ortho 数据集，这是一个大型国家行政数据库。确定了患有 BS 的 THA 和 TKA 患者，并根据患者年龄、性别、Elixhauser 合并症指数评分和手术类型（THA 或 TKA），与没有 BS 的患者进行 1:4 匹配。通过多变量分析确定并比较了 90 天不良事件的发生率。使用对数秩检验评估并比较了 5 年翻修手术的生存率。

结果

匹配后，确定了 282 例患有 BS 的 THA/TKA 患者，并与 1127 例没有 BS 的患者进行了比较。多变量分析显示，BS 患者发生任何（优势比 [OR] 2.16，P < 0.0001）、严重（OR 1.78，P = 0.0051）和轻微（OR 2.39，P < 0.0001）不良事件的风险明显高于没有 BS 的患者。5 年翻修手术生存率无显著差异（P = 0.3）。