PDF(Pubmed)
Abstract：
UNASSIGNED: While it is known that patients with end-stage renal disease (ESRD) are at an increased risk of complications following total hip arthroplasty (THA), there is a gap in the literature in comparing patients with ESRD to patients who undergo renal transplant (RT) before or after THA. This study is to address this gap by analyzing outcomes of THA in ESRD patients, RT patients, and RT candidates.
UNASSIGNED: Using the PearlDiver Mariner database, ESRD patients, RT patients, and RT candidates undergoing primary THA were identified and compared. Multivariable logistic regression analyses were done for medical complications up to 90 days and surgical complications up to 2 years. Ninety-day emergency department (ED) visits and inpatient readmission were also documented.
UNASSIGNED: A total of 7,868 patients were included: 5,092 had ESRD, 2,520 had RT before THA, and 256 were candidates for RT. Compared to patients with ESRD, RT patients demonstrated lower rates of medical complications such as pneumonia (3.61% vs. 5.99%, p = 0.039) and transfusion (4.60% vs. 7.66%, p < 0.001). Additionally, RT patients displayed decreased rates of surgical complications, including wound complications (2.70% vs. 4.22%, p = 0.001), periprosthetic joint infection (PJI) at 1 year (2.30% vs. 4.81%, p < 0.001) and 2 years (2.58% vs. 5.42%, p < 0.001), and aseptic loosening at 2 years (0.79% vs. 1.43%, p = 0.006). Similarly, when compared to RT candidates, RT patients demonstrated a lower incidence of postoperative complications, including 1-year PJI (2.30% vs. 5.08%, p = 0.013), 2-year PJI (2.58% vs. 5.08%, p = 0.028), 1-year aseptic loosening (0.56% vs. 2.73%, p < 0.001), and 2-year aseptic loosening (0.79% vs. 2.73%, p = 0.005). RT patients also had lower rates of ED visits and hospital readmissions.
UNASSIGNED: Compared to ESRD patients and RT candidates, patients with RT have a significantly lower likelihood of medical complications, PJI, aseptic hardware loosening, ED visits, and hospital readmission. Patients with ESRD on the RT waiting list should delay THA until after RT surgery. For those not eligible for RT, it is vital to take extra precautions to reduce the risk of complications.
UNASSIGNED: Using the PearlDiver Mariner database, ESRD patients, RT patients, and RT candidates undergoing primary THA were identified and compared. Multivariable logistic regression analyses were done for medical complications up to 90 days and surgical complications up to 2 years. Ninety-day emergency department (ED) visits and inpatient readmission were also documented.
UNASSIGNED: A total of 7,868 patients were included: 5,092 had ESRD, 2,520 had RT before THA, and 256 were candidates for RT. Compared to patients with ESRD, RT patients demonstrated lower rates of medical complications such as pneumonia (3.61% vs. 5.99%, p = 0.039) and transfusion (4.60% vs. 7.66%, p < 0.001). Additionally, RT patients displayed decreased rates of surgical complications, including wound complications (2.70% vs. 4.22%, p = 0.001), periprosthetic joint infection (PJI) at 1 year (2.30% vs. 4.81%, p < 0.001) and 2 years (2.58% vs. 5.42%, p < 0.001), and aseptic loosening at 2 years (0.79% vs. 1.43%, p = 0.006). Similarly, when compared to RT candidates, RT patients demonstrated a lower incidence of postoperative complications, including 1-year PJI (2.30% vs. 5.08%, p = 0.013), 2-year PJI (2.58% vs. 5.08%, p = 0.028), 1-year aseptic loosening (0.56% vs. 2.73%, p < 0.001), and 2-year aseptic loosening (0.79% vs. 2.73%, p = 0.005). RT patients also had lower rates of ED visits and hospital readmissions.
UNASSIGNED: Compared to ESRD patients and RT candidates, patients with RT have a significantly lower likelihood of medical complications, PJI, aseptic hardware loosening, ED visits, and hospital readmission. Patients with ESRD on the RT waiting list should delay THA until after RT surgery. For those not eligible for RT, it is vital to take extra precautions to reduce the risk of complications.
摘要：
虽然已知终末期肾病（ESRD）患者在全髋关节置换术（THA）后出现并发症的风险增加，文献中在比较ESRD患者与THA之前或之后接受肾移植(RT)的患者方面存在差距.这项研究是通过分析ESRD患者的THA结果来解决这一差距，RT患者，和RT候选人。
■使用PearlDiverMariner数据库，ESRD患者,RT患者，确定并比较接受原发性THA的RT候选者。对长达90天的内科并发症和长达2年的手术并发症进行了多变量逻辑回归分析。还记录了90天的急诊科（ED）就诊和住院再入院。
■总共包括7,868名患者：5,092名患有ESRD，2,520在THA之前有RT，256是RT的候选人。与ESRD患者相比，RT患者的肺炎等医疗并发症发生率较低(3.61%vs.5.99%,p=0.039）和输血（4.60%vs.7.66%,p<0.001)。此外,RT患者手术并发症发生率下降，包括伤口并发症（2.70%vs.4.22%，p=0.001),1年假体周围感染（PJI）（2.30%vs.4.81%,p<0.001)和2年(2.58%vs.5.42%,p<0.001)，和无菌性松动在2年(0.79%vs.1.43%，p=0.006)。同样，与RT候选人相比，RT患者术后并发症发生率较低，包括1年期PJI(2.30%与5.08%,p=0.013),2年期PJI（2.58%vs.5.08%,p=0.028),1年无菌性松动（0.56%vs.2.73%,p<0.001)，和2年无菌性松动(0.79%vs.2.73%,p=0.005)。RT患者的ED就诊率和再入院率也较低。
■与ESRD患者和RT候选者相比，接受RT的患者发生医疗并发症的可能性明显降低，PJI,无菌硬件松动，ED访问，再入院。RT等待名单上的ESRD患者应将THA推迟到RT手术后。对于那些不符合RT条件的人，采取额外的预防措施以降低并发症的风险至关重要。
■使用PearlDiverMariner数据库，ESRD患者,RT患者，确定并比较接受原发性THA的RT候选者。对长达90天的内科并发症和长达2年的手术并发症进行了多变量逻辑回归分析。还记录了90天的急诊科（ED）就诊和住院再入院。
■总共包括7,868名患者：5,092名患有ESRD，2,520在THA之前有RT，256是RT的候选人。与ESRD患者相比，RT患者的肺炎等医疗并发症发生率较低(3.61%vs.5.99%,p=0.039）和输血（4.60%vs.7.66%,p<0.001)。此外,RT患者手术并发症发生率下降，包括伤口并发症（2.70%vs.4.22%，p=0.001),1年假体周围感染（PJI）（2.30%vs.4.81%,p<0.001)和2年(2.58%vs.5.42%,p<0.001)，和无菌性松动在2年(0.79%vs.1.43%，p=0.006)。同样，与RT候选人相比，RT患者术后并发症发生率较低，包括1年期PJI(2.30%与5.08%,p=0.013),2年期PJI（2.58%vs.5.08%,p=0.028),1年无菌性松动（0.56%vs.2.73%,p<0.001)，和2年无菌性松动(0.79%vs.2.73%,p=0.005)。RT患者的ED就诊率和再入院率也较低。
■与ESRD患者和RT候选者相比，接受RT的患者发生医疗并发症的可能性明显降低，PJI,无菌硬件松动，ED访问，再入院。RT等待名单上的ESRD患者应将THA推迟到RT手术后。对于那些不符合RT条件的人，采取额外的预防措施以降低并发症的风险至关重要。
