摘要:视角:选择性全膝关节置换术后严重不良事件和30天再入院率:一项系统回顾和荟萃分析

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全膝关节置换术(TKA)——膝关节置换术——是一种常见的可能使用不当的手术。患者可能会因为对积极结果的不现实预期、对消极结果风险的低估以及缺乏竞争性治疗的知识而选择早产儿TKA。《平价医疗法案》要求报告严重不良事件(SAEs),并将30天再入院率(30-dRR)作为重要指标,但大多数审查涉及的患者相对较少。为了获得与TKA相关的SAEs和30-dRR的准确估计,我们汇集了28篇发表论文的数据,这些论文共包含了1000万名患者。SAEs评分:返回手术室;死亡或昏迷;静脉血栓栓塞(VTE);深部感染或脓毒症;心肌梗死;心力衰竭或心脏骤停; stroke or cerebrovascular accident; or pneumonia. For primary TKA, the SAE rate was 5.7%, and the 30-dRR was 4.8%. For revision TKA, the SAE rate was 8.5%, while the 30-dRR was 7.2%. There has been significant improvement in SAEs and 30-dRR since 2010, but TKA has a non-negligible complication rate, more pronounced in revision surgery. Postponing surgery until no revision is likely limits medical costs and may make sense for the patient, provided that effective symptomatic relief is offered.

-研究作者r·格兰特·斯蒂恩博士