PDF(Sci-hub)
Abstract：
OBJECTIVE: To examine the risk factors of surgical site infection (SSI), delayed wound healing, and death after orthopedic surgery in patients with rheumatoid arthritis (RA).
METHODS: We identified articles indexed in the Cochrane Library, PubMed, and Japan Centra Revuo Medicina Web published from 2013 to 2019 and other articles. Articles fulfilling the predefined inclusion criteria were reviewed systematically and their quality was appraised according to the Grading of Recommendations Assessment, Development, and Evaluation system with some modifications.
RESULTS: After inclusion and exclusion by full-text review, 29 articles were analyzed. Use of biological disease modifying antirheumatic drugs was a risk factor of SSI (risk ratio 1.66, 95% confidence interval 1.25-2.19), but not of delayed wound healing. RA itself was a risk factor of SSI, and oral glucocorticoid use was a risk factor of SSI in three of the four studies analyzed and of postoperative death. Age, male sex, comorbidities such as diabetes mellitus and chronic obstructive pulmonary disease, surgical factors such as foot/ankle and spine surgery and longer operative time were risk factors of those postoperative complications.
CONCLUSIONS: Patients with those factors should be dealt with appropriate cautions to strike a risk-benefit balance of orthopedic surgeries.
METHODS: We identified articles indexed in the Cochrane Library, PubMed, and Japan Centra Revuo Medicina Web published from 2013 to 2019 and other articles. Articles fulfilling the predefined inclusion criteria were reviewed systematically and their quality was appraised according to the Grading of Recommendations Assessment, Development, and Evaluation system with some modifications.
RESULTS: After inclusion and exclusion by full-text review, 29 articles were analyzed. Use of biological disease modifying antirheumatic drugs was a risk factor of SSI (risk ratio 1.66, 95% confidence interval 1.25-2.19), but not of delayed wound healing. RA itself was a risk factor of SSI, and oral glucocorticoid use was a risk factor of SSI in three of the four studies analyzed and of postoperative death. Age, male sex, comorbidities such as diabetes mellitus and chronic obstructive pulmonary disease, surgical factors such as foot/ankle and spine surgery and longer operative time were risk factors of those postoperative complications.
CONCLUSIONS: Patients with those factors should be dealt with appropriate cautions to strike a risk-benefit balance of orthopedic surgeries.
摘要：
目的：探讨手术部位感染（SSI）的危险因素，伤口愈合延迟，类风湿性关节炎（RA）患者骨科手术后死亡。
方法：我们确定了在Cochrane库中索引的文章，PubMed,和日本CentraRevuoMedicinaWeb发表了2013年至2019年的文章等。对符合预定纳入标准的文章进行了系统审查，并根据建议评估等级对其质量进行了评估。发展,和评估系统，并进行了一些修改。
结果：通过全文审查纳入和排除后，29篇文章进行了分析。使用生物疾病缓解抗风湿药物是SSI的危险因素（风险比1.66，95％置信区间1.25-2.19），但不是延迟的伤口愈合。RA本身是SSI的危险因素，在所分析的4项研究中的3项研究和术后死亡中,口服糖皮质激素是SSI的危险因素.年龄,男性,糖尿病和慢性阻塞性肺疾病等合并症，手术因素如足/踝和脊柱手术以及较长的手术时间是这些术后并发症的危险因素。
结论：具有这些因素的患者应采取适当的注意事项，以达到骨科手术的风险收益平衡。
方法：我们确定了在Cochrane库中索引的文章，PubMed,和日本CentraRevuoMedicinaWeb发表了2013年至2019年的文章等。对符合预定纳入标准的文章进行了系统审查，并根据建议评估等级对其质量进行了评估。发展,和评估系统，并进行了一些修改。
结果：通过全文审查纳入和排除后，29篇文章进行了分析。使用生物疾病缓解抗风湿药物是SSI的危险因素（风险比1.66，95％置信区间1.25-2.19），但不是延迟的伤口愈合。RA本身是SSI的危险因素，在所分析的4项研究中的3项研究和术后死亡中,口服糖皮质激素是SSI的危险因素.年龄,男性,糖尿病和慢性阻塞性肺疾病等合并症，手术因素如足/踝和脊柱手术以及较长的手术时间是这些术后并发症的危险因素。
结论：具有这些因素的患者应采取适当的注意事项，以达到骨科手术的风险收益平衡。
