Siddabattula Rohit, Thomas George, Cvek Urska, Trutschl Marjan, Wu Edward, Rao Allison J
University of Missouri, Kansas City School of Medicine, Kansas City, MO.
Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, DC.
J Hand Surg Glob Online. 2024 Sep 12;6(6):818-822. doi: 10.1016/j.jhsg.2024.06.010. eCollection 2024 Nov.
To investigate sex disparities in 30-day postoperative outcomes of total elbow arthroplasty.
The American College of Surgeons-National Surgical Quality Improvement Program files were queried for all patients who underwent a total elbow arthroplasty (TEA) between 2006 and 2020. Sex disparities in preoperative variables were studied using Fisher exact tests. Multivariate logistic regression models were used to determine the adjusted odds ratios (aOR) of postoperative outcomes for women in comparison with men.
A total of 788 patients underwent a TEA in the period of 2006-2020. Of those, 180 were men, and 608 were women. We found an increase in TEAs performed each year with a predominance in females compared to males. Additionally, our work demonstrated increased statistically significant odds of a major adverse cardiac event ( < .0001), transfusions required ( < .0001), and return to the operating room ( < .0001) as postoperative outcomes in females compared to males following TEA. Finally, we found no statistically significant difference in mortality between the groups ( = 1).
Following a TEA, women had higher adjusted postoperative odds of experiencing a major adverse cardiac event, requiring transfusion, and return to the operating room. No significant differences were found in wound outcomes, pulmonary outcomes, venous thromboembolic outcomes, sepsis, and length of stay. Overall mortality rates were similar between the two groups. Our study warrants further evaluation of the root cause of sex disparities in TEA outcomes and methods to improve care delivery to reduce those disparities.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic 2b.
探讨全肘关节置换术后30天结局的性别差异。
查询美国外科医师学会-国家外科质量改进计划档案，获取2006年至2020年间所有接受全肘关节置换术（TEA）的患者。使用Fisher精确检验研究术前变量的性别差异。多因素逻辑回归模型用于确定女性与男性相比术后结局的调整优势比（aOR）。
2006 - 2020年期间共有788例患者接受了TEA。其中，男性180例，女性608例。我们发现每年进行的TEA数量有所增加，女性比男性更为多见。此外，我们的研究表明，与男性相比，女性TEA术后发生重大不良心脏事件（<.0001）、需要输血（<.0001）和返回手术室（<.0001）的统计学显著优势增加。最后，我们发现两组之间的死亡率无统计学显著差异（=1）。
TEA术后，女性发生重大不良心脏事件、需要输血和返回手术室的调整后术后几率更高。在伤口结局、肺部结局、静脉血栓栓塞结局、败血症和住院时间方面未发现显著差异。两组的总体死亡率相似。我们的研究值得进一步评估TEA结局性别差异的根本原因以及改善护理提供以减少这些差异的方法。
研究类型/证据水平：预后性2b级。
