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Foot & Ankle Orthopaedics Pub Date : 2025-02-10 eCollection Date: 2025-01-01 DOI:10.1177/24730114251315122

Assil Mahamid, David Maman, Summer Sofer, Mykhail Pavlenko, Amr Mansour, Marah Hodruj, Yaron Berkovich, Eyal Behrbalk

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引用次数: 0

摘要

背景：踝关节置换术（AA）或踝关节融合术是一种用于治疗严重踝关节病变的外科手术，尤其适用于因骨关节炎、创伤后关节炎和夏科关节病等疾病导致的慢性疼痛和活动能力下降的患者。接受 AA 治疗的糖尿病患者由于合并血脂异常和高血压等疾病，往往面临更高的并发症风险。本研究旨在利用2016年至2019年全国住院患者样本（NIS）的数据，比较糖尿病患者与非糖尿病患者接受AA的结果：利用全国住院病人抽样数据库，根据 ICD-10 手术代码确定了 2016 年至 2019 年接受踝关节置换术的 12 325 名患者。使用χ2检验和t检验进行单变量分析，然后使用多变量逻辑回归评估糖尿病和非糖尿病患者的并发症。使用线性回归模型分析了手术量的时间趋势，并计算了指标住院期间围手术期并发症的风险比：结果：原发性骨关节炎是最常见的原因，占 AA 手术的 55.4%。多变量逻辑回归显示，糖尿病（DM）与失血（几率比 [OR] 1.59，95% CI 1.23-2.05，P = .004）、感染（OR 3.12，95% CI 2.55-3.82，P < .001）、心力衰竭（OR 1.35，95% CI 1.06-1.73，P = .01）和急性肾损伤（OR 2.42，95% CI 1.57-3.75，P = .001）的风险增加显著相关。糖尿病与肺炎之间无明显关联（OR 2.27，95% CI 1.645-4.605，P = .20）：结论：接受 AA 手术的糖尿病患者合并症和术后并发症的发生率较高，导致住院时间延长。结论：接受 AA 手术的糖尿病患者合并症和术后并发症的发生率更高，导致住院时间更长。这些研究结果突出表明，需要进行全面的术前和术后护理，以改善这一人群的预后：证据等级：三级，回顾性研究。

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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Ankle Arthrodesis: Epidemiology, Etiology, and Complications in Diabetic vs Nondiabetic Patients Using US Nationwide Inpatient Sample Data.

Background: Ankle arthrodesis (AA), or ankle fusion, is a surgical procedure used to treat severe ankle pathologies, particularly in patients with chronic pain and reduced mobility due to conditions like osteoarthritis, posttraumatic arthritis, and Charcot arthropathy. Diabetic patients undergoing AA often face higher risks of complications due to comorbidities such as dyslipidemia and hypertension. This study aims to compare the outcomes of AA in diabetic vs nondiabetic patients, using data from the Nationwide Inpatient Sample (NIS) from 2016 to 2019.

Methods: Using the Nationwide Inpatient Sample database, 12 325 patients who underwent ankle arthrodesis were identified from 2016 to 2019 based on ICD-10 procedure codes. χ² tests and t tests were used for univariate analysis, followed by multivariate logistic regression to assess complications between diabetic and nondiabetic patients. Temporal trends in surgical volume were analyzed using linear regression models, and risk ratios were calculated for perioperative complications during the index hospital stay.

Results: Primary osteoarthritis was the most common cause, accounting for 55.4% of AA procedures. Multivariate logistic regression revealed that diabetes mellitus (DM) was significantly associated with increased risks of blood loss (odds ratio [OR] 1.59, 95% CI 1.23-2.05, P = .004), infection (OR 3.12, 95% CI 2.55-3.82, P < .001), heart failure (OR 1.35, 95% CI 1.06-1.73, P = .01), and acute kidney injury (OR 2.42, 95% CI 1.57-3.75, P = .001). No significant association was observed between DM and pneumonia (OR 2.27, 95% CI 1.645-4.605, P = .20).

Conclusion: Diabetic patients undergoing AA have higher rates of comorbidities and postoperative complications, leading to longer hospital stays. These findings highlight the need for comprehensive preoperative and postoperative care to improve outcomes in this population.

Level of evidence: Level III, retrospective study.

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来源期刊

Foot & Ankle Orthopaedics Medicine-Orthopedics and Sports Medicine

CiteScore

1.20

自引率

0.00%

发文量

1152