Yoshikawa Kazuhiko, Kishi Takuya, Takamori Ayako, Goto Taku, Onozawa Koji, Takagi Kuniyasu, Kuroki Fumihiro, Akiyoshi Yuichiro, Yamamoto Takuaki
Orthopedic Surgery, International University of Health and Welfare Graduate School of Medicine, Okawa, JPN.
Cardiology, Department of Graduate School of Medicine, International University of Health and Welfare, Okawa, JPN.
Cureus. 2024 Dec 12;16(12):e75576. doi: 10.7759/cureus.75576. eCollection 2024 Dec.
The purpose of the present observational study was to examine whether there is a difference in prognosis for hemodialysis patients with or without continued orthopedic outpatient visits over five years. Methods: One hundred and thirteen hemodialysis patients who visited the dialysis center of Takagi Hospital, Okawa, Japan, as of December 2017 were included in this study. Data were collected from the medical records until December 2022. All 113 patients were divided into two groups: patients who continuously visited the orthopedic outpatient department (n = 59) and those who did not (n = 54). Patients who had orthopedic consultation were divided into three semi-groups: patients who consulted for the upper body (n = 11), the lower body (n = 22), and both the upper and lower bodies (n = 26).
During the five-year follow-up period, 13 out of 59 patients (22.0%) who had orthopedic consultation died, and this ratio tended to be lower compared to the mortality rate of patients without orthopedic consultation (37.0%) but not significant (P < 0.08). Duration of hemodialysis was significantly longer in patients with orthopedic consultation (P = 0.009). The mortality rate was significantly lower in patients who consulted for both upper and lower bodies than those without orthopedic consultation (P < 0.05, respectively). These differences were not observed in patients who consulted for only upper or lower bodies.
The mortality of hemodialysis patients was significantly lower in the group which was undertaking continuous outpatient orthopedic consultations for both upper and lower bodies, which suggested that periodical consultation with orthopedics might be critical for hemodialysis patients.
本观察性研究的目的是探讨有或没有持续进行五年骨科门诊就诊的血液透析患者的预后是否存在差异。方法：本研究纳入了截至2017年12月在日本冈山市高木医院透析中心就诊的113例血液透析患者。收集了截至2022年12月的病历数据。113例患者被分为两组：持续就诊骨科门诊的患者（n = 59）和未就诊的患者（n = 54）。接受骨科会诊的患者又分为三个亚组：上肢会诊患者（n = 11）、下肢会诊患者（n = 22）和上下肢均会诊患者（n = 26）。
在五年随访期内，59例接受骨科会诊的患者中有13例（22.0%）死亡，该比例与未接受骨科会诊患者的死亡率（37.0%）相比有降低趋势，但差异无统计学意义（P < 0.08）。接受骨科会诊的患者血液透析时间显著更长（P = 0.009）。上下肢均会诊的患者死亡率显著低于未接受骨科会诊的患者（分别为P < 0.05）。仅上肢或下肢会诊的患者未观察到这些差异。
上下肢均持续接受骨科门诊会诊的血液透析患者组死亡率显著更低，这表明定期骨科会诊对血液透析患者可能至关重要。
