PDF(Pubmed)
Abstract：
UNASSIGNED: Gout is the most prevalent form of inflammatory arthritis in the world. Total hip arthroplasty (THA) has emerged as a widely sought-after and highly effective surgical procedure for advanced hip diseases. However, there is a lack of research on the impact of gout on primary THA outcomes in large cohorts. This study aimed to address this gap by primarily investigating complications following THA in patients with or without gout.
UNASSIGNED: Patients with records of gout in the 2 years leading up to their primary THA and who also have at least 2 years of follow-up were identified using a national insurance database and compared to a 5:1 matched control. A total of 32,466 patients with gout and 161,514 patients without gout undergoing THA were identified. Multivariable logistic regression analyses were done for medical complications up to 90 days and surgical complications up to 2 years. In addition, 90-day emergency department (ED) visits and inpatient readmission were also documented.
UNASSIGNED: Patients with gout demonstrated higher rates of medical complications including deep vein thrombosis, transfusion, acute kidney injury, and urinary tract infection than non-gout patients (p < 0.001). Gout patients also showed higher rates of pulmonary embolism (p = 0.017). Increased incidences of surgical complications were identified in gout patients, specifically wound complications and periprosthetic joint infection (p < 0.001). There was an increased risk of revision for gout patients up to 90 days (p = 0.003), 1 year (p = 0.027), and 2 years (p = 0.039). There was also an increased risk of dislocation for gout patients up to 90 days (p = 0.022) and 1 year (p = 0.047), but not at 2 years. No significant difference was observed in aseptic loosening or periprosthetic fracture. Additionally, gout patients also demonstrated a higher likelihood of 90-day ED visits and readmission (p < 0.001).
UNASSIGNED: Primary THA in gout patients is associated with increased risks of multiple medical and surgical complications. Our findings provide insights into the planning and expectation of THA for patients with gout. These insights have the potential to benefit the decision-making process for gout patients considering THA.
UNASSIGNED: Patients with records of gout in the 2 years leading up to their primary THA and who also have at least 2 years of follow-up were identified using a national insurance database and compared to a 5:1 matched control. A total of 32,466 patients with gout and 161,514 patients without gout undergoing THA were identified. Multivariable logistic regression analyses were done for medical complications up to 90 days and surgical complications up to 2 years. In addition, 90-day emergency department (ED) visits and inpatient readmission were also documented.
UNASSIGNED: Patients with gout demonstrated higher rates of medical complications including deep vein thrombosis, transfusion, acute kidney injury, and urinary tract infection than non-gout patients (p < 0.001). Gout patients also showed higher rates of pulmonary embolism (p = 0.017). Increased incidences of surgical complications were identified in gout patients, specifically wound complications and periprosthetic joint infection (p < 0.001). There was an increased risk of revision for gout patients up to 90 days (p = 0.003), 1 year (p = 0.027), and 2 years (p = 0.039). There was also an increased risk of dislocation for gout patients up to 90 days (p = 0.022) and 1 year (p = 0.047), but not at 2 years. No significant difference was observed in aseptic loosening or periprosthetic fracture. Additionally, gout patients also demonstrated a higher likelihood of 90-day ED visits and readmission (p < 0.001).
UNASSIGNED: Primary THA in gout patients is associated with increased risks of multiple medical and surgical complications. Our findings provide insights into the planning and expectation of THA for patients with gout. These insights have the potential to benefit the decision-making process for gout patients considering THA.
摘要：
痛风是世界上最普遍的炎性关节炎形式。全髋关节置换术（THA）已成为治疗晚期髋关节疾病的一种广泛而有效的手术方法。然而,在大型队列中,缺乏关于痛风对原发性THA结局影响的研究.这项研究旨在通过主要调查有或没有痛风的患者在THA后的并发症来解决这一差距。
使用国家保险数据库确定了在导致原发性THA的2年内有痛风记录的患者，并且还进行了至少2年的随访，并与5：1匹配的对照进行比较。共有32,466名痛风患者和161,514名没有痛风的患者接受THA。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。此外,还记录了90天的急诊科（ED）就诊和住院再入院。
■痛风患者出现包括深静脉血栓在内的内科并发症的发生率更高，输血,急性肾损伤，与尿路感染相比，非痛风患者（p<0.001）。痛风患者的肺栓塞发生率也较高（p=0.017）。在痛风患者中发现手术并发症的发生率增加，特别是伤口并发症和假体周围感染（p<0.001）。痛风患者90天的翻修风险增加（p=0.003），1年（p=0.027），和2年（p=0.039）。痛风患者90天（p=0.022）和1年（p=0.047）的脱位风险也增加，但不是在2年。在无菌性松动或假体周围骨折方面没有观察到显着差异。此外,痛风患者90天急诊就诊和再入院的可能性也较高(p<0.001).
■痛风患者的原发性THA与多种内科和外科并发症的风险增加有关。我们的发现为痛风患者的THA计划和期望提供了见解。这些见解有可能有利于考虑THA的痛风患者的决策过程。
使用国家保险数据库确定了在导致原发性THA的2年内有痛风记录的患者，并且还进行了至少2年的随访，并与5：1匹配的对照进行比较。共有32,466名痛风患者和161,514名没有痛风的患者接受THA。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。此外,还记录了90天的急诊科（ED）就诊和住院再入院。
■痛风患者出现包括深静脉血栓在内的内科并发症的发生率更高，输血,急性肾损伤，与尿路感染相比，非痛风患者（p<0.001）。痛风患者的肺栓塞发生率也较高（p=0.017）。在痛风患者中发现手术并发症的发生率增加，特别是伤口并发症和假体周围感染（p<0.001）。痛风患者90天的翻修风险增加（p=0.003），1年（p=0.027），和2年（p=0.039）。痛风患者90天（p=0.022）和1年（p=0.047）的脱位风险也增加，但不是在2年。在无菌性松动或假体周围骨折方面没有观察到显着差异。此外,痛风患者90天急诊就诊和再入院的可能性也较高(p<0.001).
■痛风患者的原发性THA与多种内科和外科并发症的风险增加有关。我们的发现为痛风患者的THA计划和期望提供了见解。这些见解有可能有利于考虑THA的痛风患者的决策过程。
