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心血管疾病对骨科创伤患者术后并发症的影响

The Impact of Cardiovascular Diseases on Postoperative Complications in Orthopedic Trauma Patients.

作者信息

Erne Felix, Mühlberger Larissa, Ihle Christoph, Ehnert Sabrina, Histing Tina, Nüssler Andreas K, Maurer Elke

机构信息

Siegfried Weller Research Institute, BG Unfallklinik, Department of Trauma and Reconstructive Surgery, Eberhard Karls University Tuebingen, Schnarrenbergstr. 95, 72076 Tuebingen, Germany.

Department of Orthopedics and Traumatology, Diakonie-Klinikum Hospital, Rosenbergstr. 38, 70176 Stuttgart, Germany.

出版信息

Diagnostics (Basel). 2025 Jun 20;15(13):1576. doi: 10.3390/diagnostics15131576.

Abstract

Cardiovascular diseases (CVD) are recognized as a leading cause of morbidity and mortality in the population worldwide. A healthy cardiovascular system enables adaptation to trauma and physical stress. This study targets the reciprocal relation between CVD and postoperative complications after trauma surgery. In 2014, a randomized and standardized acquisition of study patients was initiated at a Level I trauma center in Germany. The burden of CVDs and the location, type, and severity of injuries were categorized. Clavien-Dindo classification was used to record postoperative complications. The study analyzed a cohort of 1262 patients, representing a diverse range of orthopedic treatment disciplines within the hospital. It highlighted that patients with lower leg fractures experienced significantly higher complication rates, particularly linked to heart valve diseases and chronic venous insufficiency. Age and sex were not found to have a significant impact. Multivariate analysis identified additional key influencing factors for the development of complications, including the number of CVDs, nutritional status, smoking habits, and mobility levels. CVDs play a pivotal role in elevating complication rates post-trauma-surgery. Trauma-related extremity conditions are notably more severe when accompanied by CVD. A personalized approach that accounts for cardiovascular risk factors could significantly improve treatment outcomes in the future.

摘要

心血管疾病(CVD)被认为是全球人口发病和死亡的主要原因。健康的心血管系统能够适应创伤和身体应激。本研究针对创伤手术后心血管疾病与术后并发症之间的相互关系。2014年,德国一家一级创伤中心开始对研究患者进行随机和标准化采集。对心血管疾病负担以及损伤的部位、类型和严重程度进行了分类。采用Clavien-Dindo分类法记录术后并发症。该研究分析了1262名患者组成的队列,这些患者代表了医院内各种骨科治疗学科。研究强调,小腿骨折患者的并发症发生率显著更高,尤其与心脏瓣膜疾病和慢性静脉功能不全有关。未发现年龄和性别有显著影响。多变量分析确定了并发症发生的其他关键影响因素,包括心血管疾病的数量、营养状况、吸烟习惯和活动水平。心血管疾病在创伤手术后并发症发生率升高方面起着关键作用。当伴有心血管疾病时,创伤相关的肢体状况明显更严重。考虑心血管危险因素的个性化方法未来可能会显著改善治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4316/12249417/5f6bc549b499/diagnostics-15-01576-g001.jpg

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