Risk Factors for Early Periprosthetic Fracture after Primary Total Hip Arthroplasty

Wesley M. Durand, M. Meftah, R. Schwarzkopf
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引用次数: 1

Abstract

Abstract Periprosthetic fracture (PPF) after total hip arthroplasty (THA) is associated with adverse outcomes. Many studies have sought to determine risk factors for PPF, though controversy exists regarding several variables. This study sought to determine risk factors for early PPF using the National Surgical Quality Improvement Program (NSQIP) dataset. Patients with a primary current procedural terminology for THA were identified. The primary outcome was reoperation/readmission for PPF within 30 days. Multivariable logistic regression was utilized to adjust for confounding factors. A total of 159,234 patients were included in the study, of whom 195 patients (0.12%) had a PPF within 30 days, with a mean day of reoperation/readmission of 14.6 (standard deviation 7.7). A total of 68 patients (34.9% of those fractured) underwent one or more reoperations. In multivariable analysis, risk factors for PPF were higher body mass index (BMI; odds ratio [OR] 1.03 per mg/kg2, 95% confidence interval [CI] 1.0–1.05) and higher preoperative leukocyte count (OR 1.04 per 103/mL, 95% CI 1.01–1.06). Among females, age (OR 1.05 per year, 95% CI 1.04–1.07) was significantly associated with PPF, but a similar difference was not observed among males (OR 1.01, 95% CI 0.98–1.04). Controlling for patient age, there was no significant difference in risk of PPF for females versus males (p = 0.2213). PPF was associated with the development of additional complications (OR 4.10, 95% CI 2.68–6.27). This study identified risk factors for PPF after primary THA. These results have implications for preoperative planning and postoperative precautions among patients with particularly elevated risk of PPF.
原发性全髋关节置换术后早期假体周围骨折的危险因素
全髋关节置换术(THA)后假体周围骨折(PPF)与不良预后相关。许多研究试图确定PPF的危险因素,尽管在几个变量上存在争议。本研究试图利用国家外科质量改进计划(NSQIP)数据集确定早期PPF的危险因素。确定了THA的主要现行手术术语的患者。主要结果为30天内PPF的再手术/再入院。采用多变量logistic回归对混杂因素进行校正。共纳入159,234例患者,其中195例(0.12%)患者在30天内发生PPF,平均再手术/再入院天数为14.6天(标准差为7.7)。共有68例患者(34.9%的骨折患者)接受了一次或多次再手术。在多变量分析中,PPF的危险因素为较高的身体质量指数(BMI);优势比[OR] 1.03 / mg/kg2, 95%可信区间[CI] 1.0-1.05)和术前白细胞计数较高(OR 1.04 / 103/mL, 95% CI 1.01-1.06)。在女性中,年龄(OR 1.05 /年,95% CI 1.04-1.07)与PPF显著相关,但在男性中没有观察到类似的差异(OR 1.01, 95% CI 0.98-1.04)。在控制患者年龄的情况下,女性与男性发生PPF的风险无显著差异(p = 0.2213)。PPF与其他并发症的发生相关(OR 4.10, 95% CI 2.68-6.27)。本研究确定了原发性THA后发生PPF的危险因素。这些结果对PPF风险特别高的患者的术前计划和术后预防具有重要意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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