虚弱对初次和翻修全髋关节置换术后预后的影响。

IF 2.3 Q2 ORTHOPEDICS
Qi-Long Jiang
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引用次数: 0

摘要

全髋关节置换术(THA)可有效治疗晚期髋关节疾病,但不同患者的预后各不相同。虚弱已成为影响这些结果的关键因素。一些研究探讨了术前影响THA预后的多种因素,强调了年龄、安大略省西部和麦克马斯特大学骨关节炎指数、流行病学研究中心抑郁量表和中心致敏指数评分在预测术后恢复方面的重要性,强调了术前的综合评估。随后的研究表明,通过医院衰弱风险评分和衰弱缺陷指数等工具测量的衰弱与不良结果显著相关,如原发性和改进型THA的30天再入院率较高、住院时间较长、费用增加、死亡率和并发症风险升高。此外,虚弱与短期不良事件有关,但强调需要标准化的虚弱测量。目前,对于THA前的脆弱性评估尚无统一的标准,这阻碍了交叉研究比较和循证指南的制定。未来的研究应侧重于建立一个考虑身体功能、合并症、认知和心理状况的通用虚弱评估标准。还需要前瞻性研究来澄清虚弱和长期THA结果之间的因果关系,并确定术前干预的可修改因素。总的来说,了解虚弱对THA结果的影响对于改善患者护理和资源利用至关重要,特别是在髋关节疾病患病率上升的老龄化人口中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Influence of frailty on postoperative outcomes following primary and revision total hip arthroplasty.

Total hip arthroplasty (THA) effectively treats advanced hip disorders, yet outcomes vary among patients. Frailty has become a crucial factor influencing these results. Several studies explored multiple preoperative factors affecting THA outcomes, highlighting the significance of age, Western Ontario and McMaster Universities Osteoarthritis Index, Center for Epidemiologic Studies Depression Scale, and central sensitization index scores in predicting post-operative recovery, emphasizing comprehensive preoperative assessments. Subsequent research has shown that frailty, measured by tools like the hospital frailty risk score and frailty deficit index, is significantly associated with adverse outcomes such as higher 30-day readmission rates, longer hospital stays, increased costs, and elevated mortality and complication risks in both primary and revision THA. Additionally, frailty related to short-term adverse events but stressed the need for standardized frailty measurement. Currently, there is no unified standard for assessing frailty before THA, which hinders cross-study comparison and evidence-based guideline development. Future research should focus on establishing a universal frailty assessment standard considering physical function, comorbidities, cognitive and psychological status. Prospective studies are also needed to clarify the causal relationship between frailty and long-term THA outcomes and identify modifiable factors for preoperative interventions. Overall, understanding the impact of frailty on THA outcomes is essential for improving patient care and resource utilization, especially in an aging population with a rising prevalence of hip disorders.

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CiteScore
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