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IF 2 3区医学 Q2 ANESTHESIOLOGY

Perioperative Medicine Pub Date : 2025-03-22 DOI:10.1186/s13741-025-00514-y

Bei-Bei Lu, Xu-Rui Liu, Qing-Song Chen, Xiao-Lin Yuan, Qian Luo, Yu-Dong Hu, Xiao-Hui Liao

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引用次数: 0

摘要

目的：本荟萃分析旨在评估慢性肾脏病对骨折患者术后并发症和存活率的影响：方法：对 PubMed、Embase、Cochrane Library 和 CNKI 数据库进行了检索，检索时间从开始到 2024 年 5 月 15 日。搜索策略主要集中在两个关键词上：透析和髋部骨折。对汇总的几率比和平均差异进行了分析。本荟萃分析采用 RevMan 5.4 进行数据分析：该荟萃分析包括 19 项研究，涉及 1,615,440 名患者。CKD组中男性、吸烟者以及术前患有糖尿病、高血压、心力衰竭、慢性肺病、冠心病、外周血管疾病、痴呆症和伤口感染等合并症的患者比例较高。慢性肾功能衰竭组术后发生心肌梗死的可能性也更大（OR = 1.67，95% CI = 1.54-1.81，P 2 = 33%）。两组在脑血管意外、肝功能衰竭、败血症和总体并发症方面没有明显差异。此外，与非 CKD 组相比，CKD 组在术后 30 天（OR = 2.71，95% CI = 2.23-3.28，P 2 = 84%）、1 年（OR = 3.17，95% CI = 2.64-3.82，P 2 = 85%）、2 年（OR = 3.06，95% CI = 2.88-3.25，P 2 = 8%）和 10 年（OR = 6.85，95% CI = 5.84-8.03，P 2 = 0%）的死亡率更高：结论：与非 CKD 组患者相比，CKD 组患者在骨折手术后大多数术后并发症的发生率上没有明显差异。结论：与非慢性阻塞性肺病组患者相比，慢性阻塞性肺病组患者在骨折手术后大多数术后并发症的发生率上没有明显差异，但慢性阻塞性肺病组患者的心肌梗死发生率明显高于非慢性阻塞性肺病组，术后30天、1年、2年和10年的死亡率明显高于非慢性阻塞性肺病组：试验注册：PREMCO CRD42025648208。

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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Effects of chronic kidney disease on complications and mortality after fracture surgery.

Purpose: The purpose of this meta-analysis was to evaluate the effects of CKD on postoperative complications and the survival of patients with fractures.

Methods: The PubMed, Embase, Cochrane Library, and CNKI databases were searched from inception to May 15, 2024. The search strategy focused on two keywords: dialysis and hip fracture. Pooled odds ratios and mean differences were analyzed. RevMan 5.4 was used for data analysis in this meta-analysis.

Results: This meta-analysis included 19 studies involving 1,615,440 patients. The CKD group had higher proportions of males, smokers, and patients with preoperative comorbidities such as diabetes, hypertension, heart failure, chronic lung disease, coronary heart disease, peripheral vascular disease, dementia, and wound infection. The CKD group also had a greater likelihood of postoperative myocardial infarction (OR = 1.67, 95% CI = 1.54-1.81, P < 0.00001, I² = 33%). There was no significant difference in cerebrovascular accidents, liver failure, sepsis, and overall complications between the two groups. Additionally, the CKD group had higher mortality rates at 30 days (OR = 2.71, 95% CI = 2.23-3.28, P < 0.00001, I² = 84%), 1 year (OR = 3.17, 95% CI = 2.64-3.82, P < 0.00001, I² = 85%), 2 years (OR = 3.06, 95% CI = 2.88-3.25, P < 0.00001, I² = 8%), and 10 years (OR = 6.85, 95% CI = 5.84-8.03, P < 0.00001, I² = 0%) post-surgery compared to the non-CKD group.

Conclusion: Compared with patients in the non-CKD group, patients in the CKD group did not significantly differ in the incidence of most postoperative complications after fracture surgery. However, the CKD group had a significantly greater incidence of myocardial infarction and markedly higher postoperative mortality rates at 30 days, 1 year, 2 years, and 10 years.

Trial registration: PROSPERO CRD42025648208.

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来源期刊

Perioperative Medicine Multiple-

自引率

3.80%

发文量

审稿时长

10 weeks