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关节镜下肩袖修复术中与充血性心力衰竭相关的术后结果

Postoperative outcomes linked to congestive heart failure in arthroscopic rotator cuff repair.

作者信息

Loyst Rachel A, Liu Steven H, Mahboubiardakani Rustin, Cerri-Droz Patricia, Walker Paul, Komatsu David E, Wang Edward D

机构信息

Stony Brook Medicine, Stony Brook, USA.

University of California, Los Angeles, USA.

出版信息

Eur J Orthop Surg Traumatol. 2025 Feb 13;35(1):71. doi: 10.1007/s00590-025-04192-w.

Abstract

PURPOSE

This study aimed to explore potential complications and risk factors associated with arthroscopic rotator cuff repair (aRCR) in patients with congestive heart failure (CHF).

METHODS

This study examined all individuals who underwent aRCR from 2015 to 2021, sourced from the American College of Surgeons National Surgical Quality Improvement database. The analysis encompassed patient demographics, comorbidities, and 30-day postoperative complications. Logistic regression was employed to analyze the postoperative complications linked to patients with CHF.

RESULTS

Compared to patients without CHF, patients with CHF undergoing aRCR were independently associated with a significantly greater likelihood of experiencing any complication (OR 3.21, 95% CI 1.89-5.48; P < .001), sepsis (OR 13.04, 95% CI 2.45-69.31; P = .003), cardiac event (OR 7.76, 95% CI 1.59-37.97; P = .011), readmission (OR 3.61, 95% CI 1.78-7.35; P < .001), and nonhome discharge (OR 5.43, 95% CI 2.27-13.02; P < .001).

CONCLUSION

CHF was identified as an independent risk factor for experiencing any complication, sepsis, cardiac event, readmission, and nonhome discharge in patients undergoing aRCR. The increased risk of postoperative complications in CHF patients after aRCR highlights the need for diligent preoperative management of these patients to reduce the risk of severe complications and enhance surgical outcomes.

LEVEL OF EVIDENCE

Level III; Retrospective Cohort Comparison Using Large Database; Prognosis Study.

摘要

目的

本研究旨在探讨充血性心力衰竭(CHF)患者行关节镜下肩袖修复术(aRCR)的潜在并发症及危险因素。

方法

本研究纳入了2015年至2021年间接受aRCR的所有个体,数据来源于美国外科医师学会国家外科质量改进数据库。分析内容包括患者人口统计学特征、合并症及术后30天并发症。采用逻辑回归分析与CHF患者相关的术后并发症。

结果

与非CHF患者相比,行aRCR的CHF患者独立发生任何并发症(比值比[OR] 3.21,95%置信区间[CI] 1.89 - 5.48;P <.001)、脓毒症(OR 13.04,95% CI 2.45 - 69.31;P =.003)、心脏事件(OR 7.76,95% CI 1.59 - 37.97;P =.011)、再入院(OR 3.61,95% CI 1.78 - 7.35;P <.001)及非回家出院(OR 5.43,95% CI 2.27 - 13.02;P <.001)的可能性显著更高。

结论

CHF被确定为行aRCR患者发生任何并发症、脓毒症、心脏事件、再入院及非回家出院的独立危险因素。CHF患者aRCR术后并发症风险增加,凸显了对这些患者进行认真术前管理以降低严重并发症风险并改善手术结局的必要性。

证据水平

III级;使用大型数据库的回顾性队列比较;预后研究。

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