暂无摘要。

Total hip arthroplasty (THA) has been quoted as \"the operation of the century\", owing to its efficacy and the substantial improvements evidenced with respect to functional patient outcomes and quality of life. However, early postoperative complications are often inevitable, hence it is imperative to take every step to prevent them and minimise morbidity and mortality. This manuscript focuses on the most common early complications following THA, namely venous thromboembolism (VTE), prosthetic joint infection, periprosthetic fracture, instability, and leg length inequality. It aims to outline effective risk stratification strategies and prevention measures that could apply to the wider Orthopaedic community.

To put forward a new index (A/G, the postoperative ratio of albumin to blood glucose) associated with complications occurring within 30-day of radical cystectomy and intestinal urinary diversion (RC-IUD).
The charts of 565 patients undergoing RC-IUD at our single center between 2008 and 2018 were reviewed. All baseline information and perioperative data were collected. We finally picked up 360 of them with complete postoperative laboratory test results to find a new index. Early complications (within 30-day) after surgery were graded using the standardized Clavien-Dindo scale. Single and multivariate logistic regression determined the association between perioperative variables and post RC-IUD complications.
A total of 485 men and 80 women with a median age of 61 years and BMI of 24.8 were included. As for intestinal urinary diversion, most patients (n = 513, 90.8%) received ileal conduits, 47 (8.3%) received Ileal orthotopic neobladders and 5 received Mainz pouch bladders (0.9%). Robotic surgeries were conducted in 311(55.0%) patients and other 254 (45.0%) accepted laparoscopic surgeries. Available laboratory markers were obtained from 359 cases. Postoperative complications occurred in 129 patients (22.8%), including 117 (90.7%) Minor (Clavien I or Clavien II events) complications, and 12 (9.3%) major (Clavien III or greater events) complications. A single logistic regression identified 4 variables associated with postoperative complications, including hypertension, surgical procedures, postoperative A/G, operating time, and blood loss. A further multivariate logistic regression identified 2 significant indices: operating time and postoperative A/G. Moreover, we built a receiver operating characteristic curve of A/G to identify a threshold of 3.65 as a new indicator of postoperative complication.
We put forward a new index named A/G associated with complications after radical cystectomy, not singular considering albumin or blood glucose any more. This novel related index may provide an early alert for RC-IUD patients thus aiding in directing individual rehabilitation and improving postoperative outcomes after RC-IUD.

BACKGROUND: This study sought to construct a nomogram for patients based on preoperative and intraoperative variables to individually predict the likelihood of complications within 30 days after primary knee arthroplasty.
METHODS: Data were obtained from the medical record of patients who underwent primary knee arthroplasty at our institution from 2015 to 2018. Preoperative and intraoperative factors were collected critically. Predictor variables include 15 common complications occurring within 30 days. The predictive model was developed using multivariable logistic regression and least absolute shrinkage and selection operator regression. Clinical usefulness and calibration of the predicting model were assessed using C-index, calibration plot, receiver operating curve, and decision curve analysis. Internal validation was assessed using the bootstrapping validation.
RESULTS: The prediction nomogram identified six variables associated with complications, including hemoglobin, tourniquet time, operative time, estimated intraoperative blood loss, American Society of Anesthesiologists Classification (ASA class) and type of anesthesia. The model displayed good discrimination with a C-index of 0.822 (95% confidence interval: 0.760-0.884), an area under the curve of 0.822 and good calibration. High C-index value of 0.810 could still be reached in the interval validation. Decision curve analysis showed that the nomogram was clinically useful when intervention was decided at the complications possibility threshold in the three percent to 100% range.
CONCLUSIONS: We constructed and validated a nomogram for predicting the probability of postoperative complications within 30 days after primary knee arthroplasty. Our nomogram may prove to be a useful tool for guiding physicians in terms of their decisions.