■强直性脊柱炎(AS)是一种炎症性脊柱关节病,常累及脊柱和骶髂关节。已证明全髋关节置换术(THA)可有效改善髋关节受累的AS患者的疼痛和功能。然而,AS患者的骨外表现和力学改变会导致并发症增加。因此,这项研究的目的是评估AS对医疗和植入物并发症的影响,falls,逗留时间,以及THA之后的再入院。
■2010年至2020年对Mariner私人保险索赔数据库进行了回顾性审查。所有THA和AS病例均使用当前程序术语进行鉴定,以及国际疾病分类第9和第10修订版。根据人口统计学和合并症概况,诊断为AS的THA患者与非AS患者1:5匹配。90天医疗并发症,falls,和再入院率,以及2年植入并发症在队列之间进行了比较.
■总共6509名AS患者与32,489名对照患者相匹配。AS组心肌梗死发生率明显增高,脑血管意外,深静脉血栓形成,肺栓塞,尿路感染,伤口并发症,急性肾损伤,肺炎,脓毒症,输血,与对照组相比时跌倒。AS组人工关节感染率明显高于对照组,位错,机械松动,和假体周围骨折(所有p<0.0001)。同样,AS组的平均住院时间和再入院时间显著延长.
■接受THA的患者的强直性脊柱炎与医疗和植入物并发症的重大风险相关,以及跌倒风险,逗留时间,和再入院率。这些发现可能使整形外科医生能够更加专心地识别那些有风险的患者,并允许更多受过教育的患者咨询和围手术期计划。
UNASSIGNED: Ankylosing spondylitis (AS) is an inflammatory spondyloarthropathy, often involving the spine and sacroiliac joints. Total hip arthroplasty (THA) has been shown to be effective in improving pain and function in patients with AS with hip involvement. However, extraskeletal manifestations and altered mechanics in those with AS leads to increased complications. Thus, the aims of this study were to assess the effects that AS has on medical and implant complications, falls, length of stay, and readmissions following THA.
UNASSIGNED: A retrospective review of the Mariner private insurance claims database was conducted from 2010 to 2020. All cases of THA and those with AS were identified using Current Procedural Terminology, and International Classification of Disease 9th and 10th revision codes. Patients who underwent THA with a diagnosis of AS were matched to non-AS patients 1:5 based on demographic and comorbidity profiles. 90-day medical complications, falls, and readmission rates, as well as 2-year implant complications were compared between cohorts.
UNASSIGNED: A total of 6509 AS patients were matched to 32,489 control patients. The AS group had significantly higher rates of myocardial infarction, cerebrovascular accident, deep vein thrombosis, pulmonary embolism, urinary tract infection, wound complications, acute kidney injury, pneumonia, sepsis, transfusions, and falls when compared to the control group. The AS group had significantly higher rates of prosthetic joint infection,
dislocation, mechanical loosening, and periprosthetic fracture (all p < 0.0001). Likewise, mean length of stay and readmissions were significantly greater in the AS group.
UNASSIGNED: Ankylosing spondylitis in patients undergoing THA is associated with significant risk of medical and implant complications, as well as fall risk, length of stay, and readmission rates. These findings may allow orthopaedic surgeons to be more attentive in identifying those patients at risk and allow for more educated patient counseling and perioperative planning.