Revision total knee arthroplasty outcomes in solid organ transplant Patients, a matched cohort study of aseptic and infected revisions.
Revision total knee arthroplasty outcomes in solid organ transplant Patients, a matched cohort study of aseptic and infected revisions.
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DOI：
10.1016/j.knee.2021.12.007
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发表时间：
2022-01
期刊：
影响因子：
1.9
通讯作者：
Stavrakis, Alexandra, I
中科院分区：
文献类型：
--
作者：
Upfill-Brown, Alexander;Wu, Shannon Y.;Hart, Christopher;Hsiue, Peter P.;Chen, Clark J.;Ponzio, Danielle;Photopoulos, Christos;Stavrakis, Alexandra, I
关键词：
既往研究表明，实体器官移植（SOT）患者接受初次全膝关节置换术（TKA）的术后并发症风险增加。本研究旨在利用大型国家数据库研究SOT患者的翻修TKA（rTKA）结局。这是一项回顾性综述，使用全国再入院数据库（NRD）和ICD-9代码识别2010-2014年接受rTKA且至少有一次SOT病史的患者。使用倾向评分匹配（PSM）来比较SOT患者与无SOT的匹配患者的rTKA结局。研究共纳入了303，867例rTKA，其中464例在SOT患者中进行。其中，非SOT和SOT患者分别进行了71，903和182次PJI。rTKA最常在肾移植患者（53.0%）中进行，其次是肝移植患者（34.3%）。对于非PJI患者，SOT患者的90天再入院率高于匹配的非SOT rTKA患者（23.2% vs 12.6%，p = 0.006）。然而，在特定rTKA并发症、后续翻修rTKA或死亡率的90天再入院率方面没有差异。在接受rTKA治疗PJI的患者中，总体90天再入院率、特定rTKA并发症再入院率、后续翻修rTKA或死亡率无差异。虽然与SOT相关的医学合并症增加使患者在rTKA后并发症的风险增加，但当基于总体医学合并症匹配患者时，SOT单独使用似乎不会增加风险。
Previous studies have demonstrated that solid organ transplant (SOT) patients undergoing primary total knee arthroplasty (TKA) are at an increased risk of postoperative complications. The purpose of this study is to utilize a large, national database to investigate revision TKA (rTKA) outcomes in SOT patients. This was a retrospective review utilizing the Nationwide Readmissions Database (NRD) and ICD-9 codes to identify patients who underwent rTKA from 2010–2014 with a history of at least one SOT. Propensity-score-matching (PSM) was used to compare rTKA outcomes in SOT patients compared to matched patients without SOT. A total of 303,867 rTKAs, with 464 of those being performed in SOT patients, were included in the study. Of these, 71,903 and 182 were performed for PJI in non-SOT and SOT patients, respectively. rTKA was performed most frequently in kidney transplant patients (53.0%) followed by liver transplant patients (34.3%). For non-PJI patients, SOT patients had a higher 90-day readmission rate than matched non-SOT rTKA patients (23.2% vs 12.6%, p = 0.006). However, there were no differences in 90-day readmission rates for specific rTKA complications, subsequent revision rTKA, or mortality. Among patients undergoing rTKA for PJI, there was no difference in overall 90-day readmission rate, readmission for specific rTKA complications, subsequent revision rTKA, or mortality. While the increased medical comorbidities associated with SOT place patients at increased risk for complications following rTKA, it appears that SOT alone does not do so when patients are matched based on overall medical comorbidity.
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DOI：
10.1002/lt.25830
发表时间：
2020-11
期刊：
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
影响因子：
--
作者：
Bittermann T;Dwinnells K;Chadha S;Wolf MS;Olthoff KM;Serper M
通讯作者：
Serper M
影响因子：
0.8
作者：
Kazley, Abby S.;Hund, Jessica Jordan;Baliga, Prabhakar
通讯作者：
Baliga, Prabhakar
影响因子：
3.5
作者：
Ledford, Cameron K.;Statz, Joseph M.;Abdel, Matthew P.
通讯作者：
Abdel, Matthew P.
影响因子：
3.5
作者：
Ledford, Cameron K.;Watters, Tyler Steven;Bolognesi, Michael P.
通讯作者：
Bolognesi, Michael P.
影响因子：
2.2
作者：
Chisholm-Burns MA;Spivey CA;Pickett LR
通讯作者：
Pickett LR