Long-term safety of total knee arthroplasty in patients with chronic kidney disease in Taiwan: A retrospective cohort study

IF 2.3 3区医学 Q2 ORTHOPEDICS

Orthopaedics & Traumatology-Surgery & Research Pub Date : 2024-11-01 DOI:10.1016/j.otsr.2024.103847

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引用次数: 0

Abstract

Background

Chronic kidney disease (CKD) is a prevalent condition in Taiwan, and the incidence of total knee arthroplasty (TKA) is on the rise. This study aimed to evaluate the postoperative results of patients with different degrees of CKD after TKA, using data from the Taiwan National Health Insurance Research Database.

Methods

The study analyzed 3078 patients who received TKA from 2012 to 2017, equally divided into three groups: none-CKD, mild CKD (without dialysis), and severe CKD (with dialysis). Propensity score matching was used to minimize selection bias.

Results

After TKA, there was no significant difference in the risk of debridement surgery for infection between the three groups (adjusted HR of mild CKD: 0.71 95% CI = 0.36–1.38, p = 0.3073; adjusted HR of severe CKD: 1.14, 95% CI = 0.63–2.06, p = 0.6616). However, CKD patients requiring dialysis had a significantly higher risk of mortality (adjusted HR: 1.98, 95% CI = 1.57–2.50, p < 0.001) and readmission within 90 days of any causes (adjusted HR: 1.83, 95% CI = 1.48–2.26, p < 0.001) than non-CKD and mild CKD patients.

Conclusion

Severe CKD patients needing dialysis after TKA have a higher risk of mortality and readmission rates than that of the non-CKD or mild CKD patients. If the patient is in the early stage of CKD, their prognosis after receiving TKA is expected to be as good as non-CKD patients.

Level of evidence

IV; well-designed cohort study.

查看原文本刊更多论文

台湾慢性肾病患者接受全膝关节置换术的长期安全性：一项回顾性队列研究。

背景：慢性肾脏病（CKD）是台湾的一种流行病，而全膝关节置换术（TKA）的发病率正在上升。本研究旨在利用台湾国民健康保险研究数据库的数据，评估不同程度的 CKD 患者接受 TKA 后的术后效果：研究分析了2012年至2017年接受TKA的3078名患者，将其平均分为三组：非CKD、轻度CKD（无透析）和重度CKD（有透析）。为减少选择偏差，采用了倾向评分匹配法：TKA术后，三组患者因感染而进行清创手术的风险无明显差异（轻度CKD的调整HR为0.71，95% CI = 0.36 - 1.38，P = 0.3073；重度CKD的调整HR为1.14，95% CI = 0.63 - 2.06，P = 0.6616）。然而，与非 CKD 和轻度 CKD 患者相比，需要透析的 CKD 患者的死亡风险（调整后 HR 1.98，95% CI = 1.57 - 2.50，P < 0.001）和 90 天内因任何原因再次入院的风险（调整后 HR 1.83，95% CI = 1.48 - 2.26，P < 0.001）明显更高：结论：与非 CKD 或轻度 CKD 患者相比，TKA 术后需要透析的重度 CKD 患者的死亡率和再入院率风险更高。如果患者处于 CKD 早期，接受 TKA 后的预后预计与非 CKD 患者一样好：证据级别：IV；精心设计的队列研究。

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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来源期刊

Orthopaedics & Traumatology-Surgery & Research 医学-外科

CiteScore

5.10

自引率

26.10%

发文量

329

审稿时长

12.5 weeks

期刊介绍： Orthopaedics & Traumatology: Surgery & Research (OTSR) publishes original scientific work in English related to all domains of orthopaedics. Original articles, Reviews, Technical notes and Concise follow-up of a former OTSR study are published in English in electronic form only and indexed in the main international databases.