背景:调查精神健康障碍与全膝关节置换术(TKA)后并发症之间联系的研究发现,患有此类疾病的个体的预后较差。因此,应更好地了解精神分裂症患者TKA术后的危险因素和结局.这项研究的目的是调查费用和住院时间,住院并发症,与精神分裂症患者TKA相关的死亡率。
方法:利用2016年至2019年的NIS数据库,使用ICD-10代码选择接受TKA的患者。将所选择的患者分为精神分裂症或对照组,住院时间,并发症,在无匹配和匹配分析中比较了两组的死亡率.
结果:我们的研究数据集包括2016年至2019年期间接受TKA的558,371例患者。样本中的1,015(0.2%)患者被诊断为精神分裂症,而其余的557,357(99.8%)患者没有精神分裂症的记录。一项无与伦比的分析发现,精神分裂症患者的住院时间更长,费用更高。急性肾衰竭,心肌梗死(MI),失血性贫血,肺炎,DVT,假体周围骨折,假肢脱位,和假体周围感染是精神分裂症组术后并发症的发生率较高。一项匹配的队列分析发现,精神分裂症患者的住院时间仍然更长,费用更高。然而,只有急性肾衰竭,失血性贫血,在TKA后的精神分裂症组中,肺炎的发生率更高。
结论:与TKA后的对照组相比,精神分裂症患者的住院时间明显更长,住院期间获得的费用也增加。急性肾衰竭,失血性贫血,在一项匹配分析中,肺炎是精神分裂症患者TKA术后风险增加的内科并发症.因此,有必要在精神分裂症患者TKA后的围手术期增加护理。
BACKGROUND: Studies investigating the link between mental health disorders and complications following total knee arthroplasty (TKA) have found worse outcomes in individuals with such disorders. Therefore, risk factors and outcomes following TKA in patients with schizophrenia should be better understood. This study aims to investigate cost and duration of hospital stay, inpatient complications, and mortality associated with TKA in patients with schizophrenia.
METHODS: Utilizing the NIS database from 2016 to 2019, patients that underwent TKA were selected using ICD-10 codes. The selected patients were classified into a schizophrenia or control group and cost, hospitalization length, complications, and mortality rates were compared between the two groups in an unmatched and matched analysis.
RESULTS: Our study dataset consisted of 558,371 patients that underwent a TKA during 2016 to 2019. 1,015 (0.2%) patients in the sample had a diagnosis of schizophrenia while the remaining 557,357 (99.8%) patients had no record of schizophrenia. An unmatched analysis found that schizophrenia patients had longer duration of hospital stay and greater charges incurred. Acute renal failure, myocardial infarction (MI), blood loss anemia, pneumonia, DVT, periprosthetic fracture, prosthetic dislocation, and periprosthetic infections were post-op complications with higher rates in the schizophrenia group. A matched cohort analysis found that schizophrenia patients still had longer duration of hospital stay and greater charges incurred. However, only acute renal failure, blood loss anemia, and pneumonia were found at higher rates in the schizophrenia group following TKA.
CONCLUSIONS: Schizophrenia patients had a significantly longer hospital stay and increased charges acquired during their stay compared to the control group following TKA. Acute renal failure, blood loss anemia, and pneumonia were medical complications with an increased risk following TKA in patients with schizophrenia in a matched analysis. Increased care during the perioperative period following TKA in individuals with schizophrenia is thus warranted.