Total Hip Arthroplasty Outcomes in Patients with Gout: A Retrospective Analysis of Matched Large Cohorts.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-08-01 Epub Date: 2024-07-12 DOI:10.4055/cios24039

Zhichang Zhang, Hanzhi Yang, Zhiwen Xu, Jialun Chi, Quanjun Cui

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引用次数: 0

Abstract

Background: Gout is the most prevalent form of inflammatory arthritis in the world. Total hip arthroplasty (THA) has emerged as a widely sought-after and highly effective surgical procedure for advanced hip diseases. However, there is a lack of research on the impact of gout on primary THA outcomes in large cohorts. This study aimed to address this gap by primarily investigating complications following THA in patients with or without gout.

Methods: Patients with records of gout in the 2 years leading up to their primary THA and who also have at least 2 years of follow-up were identified using a national insurance database and compared to a 5:1 matched control. A total of 32,466 patients with gout and 161,514 patients without gout undergoing THA were identified. Multivariable logistic regression analyses were done for medical complications up to 90 days and surgical complications up to 2 years. In addition, 90-day emergency department (ED) visits and inpatient readmission were also documented.

Results: Patients with gout demonstrated higher rates of medical complications including deep vein thrombosis, transfusion, acute kidney injury, and urinary tract infection than non-gout patients (p < 0.001). Gout patients also showed higher rates of pulmonary embolism (p = 0.017). Increased incidences of surgical complications were identified in gout patients, specifically wound complications and periprosthetic joint infection (p < 0.001). There was an increased risk of revision for gout patients up to 90 days (p = 0.003), 1 year (p = 0.027), and 2 years (p = 0.039). There was also an increased risk of dislocation for gout patients up to 90 days (p = 0.022) and 1 year (p = 0.047), but not at 2 years. No significant difference was observed in aseptic loosening or periprosthetic fracture. Additionally, gout patients also demonstrated a higher likelihood of 90-day ED visits and readmission (p < 0.001).

Conclusions: Primary THA in gout patients is associated with increased risks of multiple medical and surgical complications. Our findings provide insights into the planning and expectation of THA for patients with gout. These insights have the potential to benefit the decision-making process for gout patients considering THA.

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痛风患者的全髋关节置换术结果：对匹配大型队列的回顾性分析

背景：痛风是世界上最常见的炎症性关节炎。全髋关节置换术（THA）已成为治疗晚期髋关节疾病的一种广受欢迎的高效手术方法。然而，目前还缺乏有关痛风对大型队列中初级全髋关节置换术结果影响的研究。本研究旨在通过主要调查痛风患者或无痛风患者THA术后的并发症来填补这一空白：方法：通过国家保险数据库确定在初次 THA 术前 2 年内有痛风记录且随访至少 2 年的患者，并与 5:1 匹配的对照组进行比较。结果发现，共有 32,466 名痛风患者和 161,514 名非痛风患者接受了 THA 手术。对90天内的医疗并发症和2年内的手术并发症进行了多变量逻辑回归分析。此外，还记录了90天的急诊就诊和住院再入院情况：结果：与非痛风患者相比，痛风患者的内科并发症（包括深静脉血栓、输血、急性肾损伤和尿路感染）发生率更高（P < 0.001）。痛风患者的肺栓塞发生率也更高（P = 0.017）。痛风患者的手术并发症发生率增加，尤其是伤口并发症和假体周围关节感染（p < 0.001）。痛风患者在90天（p = 0.003）、1年（p = 0.027）和2年（p = 0.039）内翻修的风险增加。痛风患者在 90 天（p = 0.022）和 1 年（p = 0.047）内发生脱位的风险也有所增加，但在 2 年内则没有增加。在无菌性松动或假体周围骨折方面未观察到明显差异。此外，痛风患者90天急诊就诊和再入院的可能性也更高（p < 0.001）：痛风患者的初次 THA 与多种医疗和手术并发症的风险增加有关。我们的研究结果为痛风患者的 THA 计划和预期提供了启示。这些见解有可能有益于痛风患者考虑 THA 的决策过程。

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

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.