背景:术后肺部并发症(PPCs)是全髋关节置换术翻修(THAR)后最严重的并发症之一,给个人和社会带来巨大的负担。本研究使用NIS数据库检查了THAR后PPC的患病率和危险因素,确定特定的肺部并发症(SPCs)及其相关风险,包括肺炎,急性呼吸衰竭(ARF),和肺栓塞(PE)。
方法:国家住院患者样本(NIS)数据库用于本横断面研究。分析包括2010年至2019年基于NIS接受THAR的患者。可用数据包括人口统计数据,诊断和程序代码,总费用,停留时间(LOS)医院信息,保险信息,和放电。
结果:从NIS数据库,总共抽取了112,735名THAR患者。THAR手术后,PPC的总发生率为2.62%.THAR后PPCs患者表现出LOS增加,总费用,医疗保险的使用,和住院死亡率。以下变量已被确定为PPC的潜在风险因素:高龄,肺循环障碍,液体和电解质紊乱,减肥,充血性心力衰竭,转移性癌症,其他神经系统疾病(脑病,脑水肿,多发性硬化症等.),凝血病,瘫痪慢性肺病,肾功能衰竭,急性心力衰竭,深静脉血栓形成,急性心肌梗死,外周血管疾病,中风,持续创伤通气,心脏骤停,输血,关节脱位,和出血。
结论:我们的研究显示PPC的发病率为2.62%,肺炎,ARF,PE占1.24%,1.31%,和0.41%,分别。确定了PPC的多种危险因素,强调术前优化对减轻PPC和提高术后结局的重要性。
BACKGROUND: Postoperative pulmonary complications (PPCs) are among the most severe complications following total hip arthroplasty revision (THAR), imposing significant burdens on individuals and society. This
study examined the prevalence and risk factors of PPCs following THAR using the NIS database, identifying specific pulmonary complications (SPCs) and their associated risks, including pneumonia, acute respiratory failure (ARF), and pulmonary embolism (PE).
METHODS: The National Inpatient Sample (NIS) database was used for this cross-sectional
study. The analysis included patients undergoing THAR based on NIS from 2010 to 2019. Available data include demographic data, diagnostic and procedure codes, total charges, length of stay (LOS), hospital information, insurance information, and discharges.
RESULTS: From the NIS database, a total of 112,735 THAR patients in total were extracted. After THAR surgery, there was a 2.62% overall incidence of PPCs. Patients with PPCs after THAR demonstrated increased LOS, total charges, usage of Medicare, and in-hospital mortality. The following variables have been determined as potential risk factors for PPCs: advanced age, pulmonary circulation disorders, fluid and electrolyte disorders, weight loss, congestive heart failure, metastatic cancer, other neurological disorders (encephalopathy, cerebral edema, multiple sclerosis etc.), coagulopathy, paralysis, chronic pulmonary disease, renal failure, acute heart failure, deep vein thrombosis, acute myocardial infarction, peripheral vascular disease, stroke, continuous trauma ventilation, cardiac arrest, blood transfusion, dislocation of joint, and hemorrhage.
CONCLUSIONS: Our
study revealed a 2.62% incidence of PPCs, with pneumonia, ARF, and PE accounting for 1.24%, 1.31%, and 0.41%, respectively. A multitude of risk factors for PPCs were identified, underscoring the importance of preoperative optimization to mitigate PPCs and enhance postoperative outcomes.