PDF(Pubmed)
Abstract：
UNASSIGNED: Nerve injury following total hip arthroplasty (THA) is a rare but serious adverse event. While prior studies have reported risk factors for nerve injury related to THA, they are limited to institutional data or small sample sizes. The current study aimed to leverage a large, national database to assess independent risk factors for sustaining nerve injury with THA.
UNASSIGNED: The 2010-2021 PearlDiver M157 database was queried for adult THA cases. Those with nerve injury within 90 days of THA were identified. Patient age, sex, body mass index (BMI), Elixhauser comorbidity index (ECI), fracture indication, and surgery type (index vs revision) were assessed for correlation with nerve injury by multivariate analyses.
UNASSIGNED: Out of 750,695 THAs, 2659 (0.35%) had nerve injuries. Multivariate analysis revealed independent predictors of nerve injury in decreasing odds ratio (OR) order to include: revision procedure (OR: 2.13), female sex (OR 1.35), ECI (ECI 1-2 [OR 1.27], ECI 3-4 [OR 1.43], and ECI ≥5 [OR 1.59]) and age (OR 1.02 per decade decrease) (P < .05 for each). Pertinent negatives by multivariate analysis included underweight BMI (<20), and fracture indication. Individuals with morbidly obese BMI status (≥35) had a decreased risk of nerve injury (OR 0.84, P = .019).
UNASSIGNED: THA-related nerve injury was found to be low at 0.35%. Factors independently associated with this adverse outcome were defined, of which the greatest risk was seen in revision procedures. These risk factors, derived from the largest cohort to date, may be helpful for risk stratification and patient counseling.
UNASSIGNED: The 2010-2021 PearlDiver M157 database was queried for adult THA cases. Those with nerve injury within 90 days of THA were identified. Patient age, sex, body mass index (BMI), Elixhauser comorbidity index (ECI), fracture indication, and surgery type (index vs revision) were assessed for correlation with nerve injury by multivariate analyses.
UNASSIGNED: Out of 750,695 THAs, 2659 (0.35%) had nerve injuries. Multivariate analysis revealed independent predictors of nerve injury in decreasing odds ratio (OR) order to include: revision procedure (OR: 2.13), female sex (OR 1.35), ECI (ECI 1-2 [OR 1.27], ECI 3-4 [OR 1.43], and ECI ≥5 [OR 1.59]) and age (OR 1.02 per decade decrease) (P < .05 for each). Pertinent negatives by multivariate analysis included underweight BMI (<20), and fracture indication. Individuals with morbidly obese BMI status (≥35) had a decreased risk of nerve injury (OR 0.84, P = .019).
UNASSIGNED: THA-related nerve injury was found to be low at 0.35%. Factors independently associated with this adverse outcome were defined, of which the greatest risk was seen in revision procedures. These risk factors, derived from the largest cohort to date, may be helpful for risk stratification and patient counseling.
摘要：
■全髋关节置换术（THA）后神经损伤是一种罕见但严重的不良事件。虽然先前的研究报道了与THA相关的神经损伤的危险因素，它们仅限于机构数据或小样本量。当前的研究旨在利用大量的，国家数据库，以评估THA维持神经损伤的独立危险因素。
■查询了2010-2021年PearlDiverM157数据库中的成人THA病例。确定了在THA后90天内有神经损伤的患者。患者年龄,性别,体重指数（BMI），Elixhauser合并症指数（ECI），骨折指征,通过多变量分析评估手术类型(指数vs翻修)与神经损伤的相关性。
■在750,695个TAs中，2659人(0.35%)有神经损伤。多变量分析显示神经损伤的独立预测因子以比值比（OR）降低为顺序，包括：修正程序（OR：2.13），女性（OR1.35），ECI(ECI1-2[OR1.27],ECI3-4[OR1.43],和ECI≥5[OR1.59]）和年龄（每十年减少1.02）（每个P<0.05）。多变量分析的相关阴性包括体重不足的BMI(<20)，和骨折指征。病态肥胖BMI状态（≥35）的个体神经损伤风险降低（OR0.84，P=.019）。
■发现THA相关的神经损伤较低，为0.35％。定义了与这种不良结局独立相关的因素，其中最大的风险是在修订程序中看到的。这些危险因素,来自迄今为止最大的队列，可能有助于风险分层和患者咨询。
■查询了2010-2021年PearlDiverM157数据库中的成人THA病例。确定了在THA后90天内有神经损伤的患者。患者年龄,性别,体重指数（BMI），Elixhauser合并症指数（ECI），骨折指征,通过多变量分析评估手术类型(指数vs翻修)与神经损伤的相关性。
■在750,695个TAs中，2659人(0.35%)有神经损伤。多变量分析显示神经损伤的独立预测因子以比值比（OR）降低为顺序，包括：修正程序（OR：2.13），女性（OR1.35），ECI(ECI1-2[OR1.27],ECI3-4[OR1.43],和ECI≥5[OR1.59]）和年龄（每十年减少1.02）（每个P<0.05）。多变量分析的相关阴性包括体重不足的BMI(<20)，和骨折指征。病态肥胖BMI状态（≥35）的个体神经损伤风险降低（OR0.84，P=.019）。
■发现THA相关的神经损伤较低，为0.35％。定义了与这种不良结局独立相关的因素，其中最大的风险是在修订程序中看到的。这些危险因素,来自迄今为止最大的队列，可能有助于风险分层和患者咨询。
