术前低白蛋白血症对骨科创伤患者术后再入院、再手术和死亡率的影响：一项系统综述和荟萃分析

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-06-23 DOI:10.1016/j.jcot.2025.103108

Eric H. Tischler , Shivasuryan Vummidi , Jake R. McDermott , Hallie A. Tiburzi , Jonathan M. Gross , Nishant Suneja

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引用次数: 0

摘要

背景/目的在内科和外科患者中，手术后血清低白蛋白血症（3.5 g/dL）是与术后再入院、再手术和死亡率相关的模糊参考阈值。本系统综述和荟萃分析评估了术前血清白蛋白与骨科创伤患者再入院、再手术和死亡率的具体作用。方法检索spubmed /MEDLINE、Embase、Ovid、Cochrane中央对照试验注册库（Central）、试验注册库（clinicaltrials.gov）和Scopus，寻找符合以下标准的合格研究：1)回顾性和前瞻性观察性研究或随机对照试验（RCTs）； 2)骨科创伤性THA、TKA、TSA的成年患者；3)基线低白蛋白血症患者与无基线低白蛋白血症患者术后再入院、再手术和死亡率的比较队列评价。普洛斯彼罗号码是CRD420251053172。结果纳入9项研究。8项研究的荟萃分析发现，低白蛋白血症术后死亡率增加2.42倍（95% CI = 1.75-3.34）。三项研究的荟萃分析发现，低白蛋白血症与再手术和再入院分别增加1.74倍（95% CI = 1.32-2.29）和1.96倍（95% CI = 1.11-3.48）相关。亚组分析发现，四项治疗关节置换术患者的研究和三项治疗未进行关节置换术患者的研究的差异为1.77倍（95% CI = 1.46-2.13）。术后死亡风险= 4.02 （95% CI = 1.77 ~ 13.86）。结论：虽然基线低白蛋白血症与骨科创伤患者术后再入院、再手术和死亡率显著相关，但我们警告不要使用单一白蛋白阈值来评估术后风险。

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The implications of preoperative hypoalbuminemia on postoperative readmission, reoperation, and mortality among orthopaedic trauma patients: A systematic review and meta-analysis

Background/aims

Preoperative serum hypoalbuminemia (<3.5 g/dL) is the blanketed referenced threshold associated with postoperative readmission, reoperation, and mortality among medical and surgical patients. This systematic review and meta-analysis evaluates the specific role of preoperative serum albumin and readmission, reoperation, and mortality among orthopaedic trauma patients.

Methods

PubMed/MEDLINE, Embase, Ovid, Cochrane Central Register of Controlled Trials (CENTRAL) the trial register (clinicaltrials.gov), and Scopus were searched for eligible studies meeting the following criteria: 1) retrospective and prospective observational studies or randomized controlled trials (RCTs), 2) adult patients with orthopaedic traumatic THA,TKA,TSA; 3) comparative cohort evaluation of patients with and without baseline hypoalbuminemia and postoperative readmission, reoperation, and mortality rates. The PROSPERO number is CRD420251053172.

Results

Nine studies were included. A meta-analysis of eight studies found hypoalbuminemia to have 2.42-fold (95 % CI = 1.75–3.34) increased risk of post-operative mortality. Meta-analyses of three studies found that hypoalbuminemia was associated with a 1.74-fold (95 % CI = 1.32–2.29) and 1.96-fold (95 % CI = 1.11–3.48) respective increase in reoperation and readmission. Subgroup analysis of four studies that treated patients with arthroplasty and three studies that treated patients without arthroplasty found a 1.77-fold (95 % CI = 1.46–2.13). and = 4.02 (95 % CI = 1.77–13.86) risk of postoperative mortality, respectively.

Conclusion

While baseline hypoalbuminemia is significantly associated with postoperative readmission, reoperation, and mortality among orthopaedic trauma patients, we caution against the use of a single albumin threshold to assess postoperative risk.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.