目的:术前贫血增加术后发病率,死亡率,和同种异体输血的风险。然而,在接受全髋关节置换术和全膝关节置换术(TKA)的患者中,术前贫血的发生率及其与术后结局的关系尚未见报道.
方法:我们通过PubMed进行了全面的文献检索,科克伦图书馆,辛辛恩之网,和Embase从开始到2023年7月,调查全关节置换术患者术前贫血的患病率,手术前贫血和非贫血患者之间的合并症,和术后结果。分析术后结局.使用随机效应模型计算总体患病率,研究之间的异质性通过Cochran的Q检验进行检验,并通过I2统计量进行量化。进行亚组分析和荟萃回归分析以确定异质性的来源。通过漏斗图评估发表偏倚,并通过Egger检验进行验证。
结果:共纳入21项研究,共369,101个样本,所有研究均为回顾性队列研究.3项研究质量高,18项研究质量中等。结果表明,等待关节置换术的患者术前贫血的患病率为22%;亚组分析显示,等待全膝关节置换术的患者术前贫血的患病率最高;美洲发现术前贫血的患病率最高;女性人群的术前贫血发生率高于男性人群;有术前贫血史的术前贫血发生率在女性人群中高于男性人群。有术前贫血史的患者;有术前贫血史的关节置换患者感染风险增加,术后输血率,术后输血,下肢深静脉血栓,在医院的日子,三个月内重新入院,和死亡率与术前没有贫血的患者相比。
结论:等待全关节置换术的患者术前贫血的患病率为22%,在TKA和接受翻修的女性患者中更高,而术前贫血不利于患者的术后恢复,会增加术后并发症的风险,输血率,在医院的日子,再入院率,和死亡率。
OBJECTIVE: Preoperative anemia increases postoperative morbidity, mortality, and the risk of allogeneic transfusion. However, the incidence of preoperative anemia in patients undergoing total hip arthroplasty and total knee arthroplasty (TKA) and its relationship to postoperative outcomes has not been previously reported.
METHODS: We conducted a comprehensive literature search through PubMed, Cochrane Library, Web of Sincien, and Embase from inception to July 2023 to investigate the prevalence of preoperative anemia in patients undergoing Total Joint Arthroplasty, comorbidities between anemic and non-anemicpatients before surgery, and postoperative outcomes. postoperative outcomes were analyzed. Overall prevalence was calculated using a random-effects model, and heterogeneity between studies was examined by Cochran\'s Q test and quantified by the I2 statistic. Subgroup analyses and meta-regression analyses were performed to identify sources of heterogeneity. Publication bias was assessed by funnel plots and validated by Egger\'s test.
RESULTS: A total of 21 studies with 369,101 samples were included, all of which were retrospective cohort studies. 3 studies were of high quality and 18 studies were of moderate quality. The results showed that the prevalence of preoperative anemia was 22% in patients awaiting arthroplasty; subgroup analyses revealed that the prevalence of preoperative anemia was highest in patients awaiting revision of total knee arthroplasty; the highest prevalence of preoperative anemia was found in the Americas; preoperative anemia was more prevalent in the female than in the male population; and preoperative anemia with a history of preoperative anemia was more common in the female than in the male population. patients with a history of preoperative anemia; patients with joint
replacement who had a history of preoperative anemia had an increased risk of infection, postoperative blood transfusion rate, postoperative blood transfusion, Deep vein thrombosis of the lower limbs, days in hospital, readmission within three months, and mortality compared with patients who did not have preoperative anemia.
CONCLUSIONS: The prevalence of preoperative anemia in patients awaiting total joint arthroplasty is 22%, and is higher in TKA and female patients undergoing revision, while preoperative anemia is detrimental to the patient\'s postoperative recovery and will increase the risk of postoperative complications, transfusion rates, days in the hospital, readmission rates, and mortality.