Chinese Medical Sciences Journal ›› 2022, Vol. 37 ›› Issue (4): 303-308.doi: 10.24920/003938

• 论著 • 上一篇    下一篇

全膝关节置换术患者术后严重并发症的危险因素

马璐璐1,虞雪融1,*(),翁习生2,林进2,金今2,钱文伟2,黄宇光1   

  1. 1中国医学科学院 北京协和医学院 北京协和医院麻醉科, 北京 100730
    2中国医学科学院 北京协和医学院 骨科, 北京 100730
  • 收稿日期:2021-05-21 接受日期:2022-01-11 出版日期:2022-12-31 发布日期:2022-12-13
  • 通讯作者: 虞雪融 E-mail:yxr313@aliyun.com

Possible Risk Factors for Severe Complications Occurring after Primary Total Knee Arthroplasty

Lulu Ma1,Xuerong Yu1,*(),Xisheng Weng2,Jin Lin2,Jin Jin2,Wenwei Qian2,Yuguang Huang1   

  1. 1Department of Anesthesiology, Beijing 100730, China
    2Department of Orthopedic Surgery;Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  • Received:2021-05-21 Accepted:2022-01-11 Published:2022-12-31 Online:2022-12-13
  • Contact: Xuerong Yu E-mail:yxr313@aliyun.com

摘要:

目的 术后因严重并发症再次入院是全膝关节置换术后骨科医生最关注的问题之一。本研究分析了全膝关节置换术患者术后严重并发症的危险因素。
方法 我们回顾分析了2,974例于2013年7月至2019年6月在我院行全膝关节置换术患者的病历资料。Clavien-Dindo分级≥Ⅲ级定义为严重并发症。采用二元Logistic回归确定术后严重并发症的危险因素。
结果 全膝关节置换术患者术后并发症的发生率为6.8%,而严重并发症的发生率为2.5%。男性(OR=2.178,95%CI: 1.324~3.585,P = 0.002)、年龄>75岁(OR=1.936,95%CI: 1.155~3.244,P = 0.012)、心律失常(OR=2.913,95%CI: 1.350~6.285,P = 0.006)和脑血管疾病(OR=2.804,95%CI: 1.432~5.489,P = 0.003)是术后严重并发症的危险因素。
结论 对于具有高危因素的患者,如高龄、男性、伴有心律失常和脑血管疾病,应加强术后并发症的监测。

关键词: 全膝关节置换术, 术后并发症, 危险因素

Abstract:

Objective Total knee arthroplasty is one of the most common orthopedic surgeries. Readmission due to severe complications after total knee arthroplasty is a grave concern to surgeons. In this study, we evaluated the risk factors for severe complications after primary total knee arthroplasty.
Methods We retrospectively collected clinical data of 2,974 patients who underwent primary total knee arthroplasty from July 2013 to June 2019 in our hospital. Postoperative complication ≥ grade Ⅲ was defined as severe complication according to Clavien-Dindo classification system. Binary logistic regression was used to identify the predictive risk factors for severe complications.
Results The complication rate after primary total knee arthroplasty was 6.8% and severe complication rate was 2.5%. Male (OR = 2.178, 95%CI: 1.324-3.585, P= 0.002), individuals above 75 years old (OR = 1.936, 95%CI: 1.155-3.244, P= 0.012), arrhythmia (OR = 2.913, 95%CI: 1.350-6.285, P= 0.006) and cerebrovascular disease (OR = 2.804, 95%CI: 1.432-5.489, P= 0.003) were predictive risk factors for severe complications after primary total knee arthroplasty.
Conclusion Advanced age, male, arrhythmia, and cerebrovascular disease might be patients-related risk factors for postoperative severe complications after primary total knee arthroplasty. Special attention should be paid to patients with risk factors.

Key words: primary total knee arthroplasty, postoperative complications, risk factor

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