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比较初次全髋关节置换术患者的全身麻醉和区域麻醉:韩国国民健康保险数据分析

Comparing general and regional anesthesia in patients undergoing primary total hip arthroplasty: analysis of national health insurance data in Korea.

作者信息

Lee Seungyoung, Ahn Eunjin, Kim Min Kyoung, White Fletcher A, Chung Euiheon, Chung YongHun

机构信息

Department of Anesthesiology and Pain Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea.

Department of Anesthesiology and Pain Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeonsi, Republic of Korea.

出版信息

Front Med (Lausanne). 2025 Mar 17;12:1557053. doi: 10.3389/fmed.2025.1557053. eCollection 2025.

Abstract

OBJECTIVES

To compare the effects of general and regional anesthesia on clinical outcomes following primary total hip arthroplasty (THA).

METHODS

This retrospective study using data from the Korean National Health Insurance Research Database included 1,522 patients who underwent THA under general anesthesia ( = 640) or regional anesthesia ( = 882) between 2002 and 2015. We compared the mortality and complication rates within 30 days after surgery.

RESULTS

Prosthesis failure (1.56% vs. 0.45%,  = 0.025), admission to the intensive care unit (9.53 vs. 5.44%, 0.0023), and total cost (₩7,332,515 vs. ₩6,833,295,  < 0.0001) were higher in the general anesthesia group than in the regional anesthesia group. No significant differences were observed in mortality (0.94% vs. 0.57%,  = 0.54), transfusion rate (81.1% vs. 80.9% = 0.94), length of hospital stay (45 vs. 45 days,  = 0.23), or other complications between the groups. Similar results were observed in propensity-score matched analysis ( = 640 patients per group).

CONCLUSION

Our study showed that both anesthesia types resulted in comparable mortality and complication rates in patients who underwent THA, but the costs differed.

摘要

目的

比较全身麻醉和区域麻醉对初次全髋关节置换术(THA)术后临床结局的影响。

方法

这项回顾性研究使用了韩国国民健康保险研究数据库中的数据,纳入了2002年至2015年间接受全身麻醉(n = 640)或区域麻醉(n = 882)下THA的1522例患者。我们比较了术后30天内的死亡率和并发症发生率。

结果

全身麻醉组的假体失败率(1.56%对0.45%,P = 0.025)、入住重症监护病房的比例(9.53%对5.44%,P = 0.0023)和总费用(7,332,515韩元对6,833,295韩元,P < 0.0001)均高于区域麻醉组。两组在死亡率(0.94%对0.57%,P = 0.54)、输血率(81.1%对80.9%,P = 0.94)、住院时间(45天对45天,P = 0.23)或其他并发症方面未观察到显著差异。倾向评分匹配分析(每组n = 640例患者)也观察到了类似结果。

结论

我们的研究表明,两种麻醉方式在接受THA的患者中导致的死亡率和并发症发生率相当,但费用有所不同。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d87/11955599/766fcdd731a8/fmed-12-1557053-g001.jpg

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