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全肘关节翻修置换术与30天并发症的高发生率相关:一项全国性数据库的描述性分析。

Revision total elbow arthroplasty is associated with a high rate of 30-day complications: A descriptive analysis of a national database.

作者信息

El-Najjar Dany, Mehta Apoorva, Gupta Puneet, Peterson Joel R, Marigi Erick M, Rogalski Brandon, Trofa David P, Levine William N, Jobin Charles M

机构信息

Department of Orthopaedic Surgery, Columbia University Irving Medical Center, New York, NY, USA.

Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN, USA.

出版信息

Shoulder Elbow. 2024 Aug 2:17585732241269001. doi: 10.1177/17585732241269001.

Abstract

INTRODUCTION

Revision total elbow arthroplasty (TEA) is indicated for component loosening, periprosthetic joint infection, and fractures. Previous investigations into revision TEA complications have small sample sizes and limited exploration of acute complications. This study aims to characterize the 30-day complications and associated demographics of patients undergoing revision TEA using a large national database.

METHODS

The 2015-2020 American College of Surgeons National Surgical Quality Improvement Program database was used to identify all revision TEA patients.

RESULTS

The analysis included 158 patients (average age 62.6 years). The overall complication rate was 13.9% ( = 22). The most common 30-day complications were organ/space surgical site infection (3.8%,  = 6), unplanned readmission (3.2%,  = 5), intraoperative or postoperative transfusion (3.2%,  = 5), and unplanned reoperation (1.9%,  = 3). Patients with a history of dyspnea or steroid/immunosuppressant use for a chronic condition had significantly higher rates of bleeding requiring transfusion ( = .029 and  = .021, respectively). Additionally, patients aged 80 years or older had a significantly higher rate of unplanned readmission ( = .032).

CONCLUSION

Revision TEA has a 13.9% rate of complications within 30-days of surgery, with most involving surgical site infection, unplanned readmission, and blood transfusion.

LEVEL OF EVIDENCE

IV.

摘要

引言

翻修全肘关节置换术(TEA)适用于假体松动、假体周围关节感染和骨折。既往对翻修TEA并发症的研究样本量较小,且对急性并发症的探索有限。本研究旨在利用一个大型国家数据库,描述接受翻修TEA患者的30天并发症及相关人口统计学特征。

方法

使用2015 - 2020年美国外科医师学会国家外科质量改进计划数据库来识别所有翻修TEA患者。

结果

分析纳入158例患者(平均年龄62.6岁)。总体并发症发生率为13.9%(n = 22)。最常见的30天并发症为器官/腔隙手术部位感染(3.8%,n = 6)、计划外再次入院(3.2%,n = 5)、术中或术后输血(3.2%,n = 5)以及计划外再次手术(1.9%,n = 3)。有呼吸困难病史或因慢性病使用类固醇/免疫抑制剂的患者,输血相关出血发生率显著更高(分别为P = 0.029和P = 0.021)。此外,80岁及以上患者计划外再次入院发生率显著更高(P = 0.032)。

结论

翻修TEA术后30天内并发症发生率为13.9%,大多数并发症涉及手术部位感染、计划外再次入院和输血。

证据级别

IV级。

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