Risk Factors for Wound Complication following Primary Total Hip Arthroplasty.

Kyleen Jan, Arya Dadhania, Michael Foy, Anshum Sood, Mark Gonzalez
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Abstract

This study assessed the National Surgical Quality Improvement Program (NSQIP), which provides data on 30-day post-operative complications from 500+ institutions, to identify risk factors for wound complications in patients undergoing primary total hip arthroplasty (THA). Patients undergoing primary THA between 2010-2017 were retrospectively reviewed. Patients experiencing post-operative wound complications were stratified based on pre-operative characteristics. Multivariate regression model was used to assess these characteristics as independent risk factors for post-operative complications. Of 119,096 patients undergoing primary THA, 1,264 (1.06%), 280 (0.2%), 622 (0.52%) and 139 (0.12%) experienced wound complications, deep surgical site infection, superficial surgical site infection, and wound dehiscence, respectively. Pre-operative transfusion (p < 0.0001), steroid use (p = 0.01), and obesity (p < 0.0001) were risk factors for wound dehiscence. Pre-operative transfusion (p < 0.0001), cardiac comorbidities (p = 0.02), and steroid use (p = 0.01) were risk factors for superficial surgical site infection. Assessment of the NSQIP identified modifiable risk factors for wound complications following primary THA, including pre-operative transfusion, steroid use, and obesity. (Journal of Surgical Orthopaedic Advances 31(4):242-247, 2022).

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初次全髋关节置换术后伤口并发症的危险因素。
本研究评估了国家手术质量改进计划(NSQIP),该计划提供了来自500多家机构的术后30天并发症数据,以确定原发性全髋关节置换术(THA)患者伤口并发症的危险因素。对2010-2017年间接受原发性THA的患者进行回顾性分析。根据术前特征对术后伤口并发症患者进行分层。采用多变量回归模型评估这些特征作为术后并发症的独立危险因素。119096例原发性THA患者中,分别有1264例(1.06%)、280例(0.2%)、622例(0.52%)和139例(0.12%)出现创面并发症、深部手术部位感染、浅表手术部位感染和创面裂开。术前输血(p < 0.0001)、使用类固醇(p = 0.01)和肥胖(p < 0.0001)是创面裂开的危险因素。术前输血(p < 0.0001)、心脏合并症(p = 0.02)和类固醇使用(p = 0.01)是浅表手术部位感染的危险因素。NSQIP的评估确定了原发性全髋关节置换术后伤口并发症的可改变危险因素,包括术前输血、类固醇使用和肥胖。[j] .外科骨科进展,31(4):242-247,2022。
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