Risk of Postoperative Complications After Total Hip and Total Knee Arthroplasty in Behcet Syndrome Patients.
Journal
Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews
ISSN: 2474-7661
Titre abrégé: J Am Acad Orthop Surg Glob Res Rev
Pays: United States
ID NLM: 101724868
Informations de publication
Date de publication:
01 Oct 2024
01 Oct 2024
Historique:
received:
31
01
2024
accepted:
10
08
2024
medline:
11
10
2024
pubmed:
11
10
2024
entrez:
11
10
2024
Statut:
epublish
Résumé
Behcet syndrome (BS), a multisystem autoimmune disorder, has unclear effects on outcomes after total hip arthroplasty (THA) and total knee arthroplasty (TKA). This study assessed the relative risk of perioperative adverse events in patients with BS. This retrospective cohort study used the PearlDiver M157Ortho data set, a large national administrative database. Total hip arthroplasty and TKA patients with BS were identified and matched 1:4 to those without BS based on patient age, sex, Elixhauser Comorbidity Index scores, and procedure performed (THA or TKA). The incidence of 90-day adverse events was determined and compared by multivariate analysis. 5-year survival to revision surgeries was assessed and compared with the log-rank test. After matching, 282 THA/TKA patients with BS were identified and compared with 1127 without BS. On multivariate analysis, patients with BS were at independently greater risk of aggregated any (odds ratio [OR] 2.16, P < 0.0001), serious (OR 1.78, P = 0.0051), and minor (OR 2.39, P < 0.0001) adverse events compared with those without BS. No significant difference was observed in 5-year survival to revision surgery (P = 0.3). Patients with BS undergoing THA or TKA experienced markedly greater 90-day postoperative adverse events. The findings underscore the need for optimized perioperative management for patients with BS undergoing arthroplasty.
Sections du résumé
BACKGROUND
BACKGROUND
Behcet syndrome (BS), a multisystem autoimmune disorder, has unclear effects on outcomes after total hip arthroplasty (THA) and total knee arthroplasty (TKA). This study assessed the relative risk of perioperative adverse events in patients with BS.
METHODS
METHODS
This retrospective cohort study used the PearlDiver M157Ortho data set, a large national administrative database. Total hip arthroplasty and TKA patients with BS were identified and matched 1:4 to those without BS based on patient age, sex, Elixhauser Comorbidity Index scores, and procedure performed (THA or TKA). The incidence of 90-day adverse events was determined and compared by multivariate analysis. 5-year survival to revision surgeries was assessed and compared with the log-rank test.
RESULTS
RESULTS
After matching, 282 THA/TKA patients with BS were identified and compared with 1127 without BS. On multivariate analysis, patients with BS were at independently greater risk of aggregated any (odds ratio [OR] 2.16, P < 0.0001), serious (OR 1.78, P = 0.0051), and minor (OR 2.39, P < 0.0001) adverse events compared with those without BS. No significant difference was observed in 5-year survival to revision surgery (P = 0.3).
CONCLUSIONS
CONCLUSIONS
Patients with BS undergoing THA or TKA experienced markedly greater 90-day postoperative adverse events. The findings underscore the need for optimized perioperative management for patients with BS undergoing arthroplasty.
Identifiants
pubmed: 39392934
doi: 10.5435/JAAOSGlobal-D-24-00040
pii: 01979360-202410000-00005
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.
Références
Foot Ankle Orthop. 2022 Oct 28;7(4):24730114221134255
pubmed: 36324696
Ann Rheum Dis. 1997 Aug;56(8):455-7
pubmed: 9306866
J Am Acad Orthop Surg. 2023 Apr 1;31(7):357-363
pubmed: 36735406
J Am Acad Orthop Surg. 2023 Sep 15;31(18):984-989
pubmed: 37253245
N Am Spine Soc J. 2022 Mar 24;10:100115
pubmed: 35392022
Medicine (Baltimore). 2012 Jan;91(1):35-48
pubmed: 22210555
Medicina (Kaunas). 2024 Mar 29;60(4):
pubmed: 38674208
Patholog Res Int. 2012;2012:493015
pubmed: 21977335
Ocul Immunol Inflamm. 2012 Oct;20(5):324-35
pubmed: 23030353
Arthritis Rheum. 2012 Dec;64(12):3839-49
pubmed: 23192790
N Am Spine Soc J. 2022 Jun 22;11:100136
pubmed: 35783003
Arch Mal Coeur Vaiss. 2006 Sep;99(9):786-90
pubmed: 17067096
Nat Rev Dis Primers. 2021 Sep 16;7(1):67
pubmed: 34531393
Spine J. 2023 Jul;23(7):990-996
pubmed: 36990283
Semin Arthritis Rheum. 2019 Oct;49(2):296-302
pubmed: 30952423
Int Orthop. 2023 Aug;47(8):1989-1994
pubmed: 37249630
World J Gastroenterol. 2015 Apr 7;21(13):3801-12
pubmed: 25852265
Jpn J Radiol. 2022 Feb;40(2):107-119
pubmed: 34398372
N Am Spine Soc J. 2022 May 11;10:100122
pubmed: 35637647
Blood Coagul Fibrinolysis. 2000 Jul;11(5):421-3
pubmed: 10937802
Zhonghua Jie He He Hu Xi Za Zhi. 2017 May 12;40(5):343-348
pubmed: 28482419
Ann Rheum Dis. 2009 Jul;68(7):1119-24
pubmed: 18684744
Spine J. 2023 Nov;23(11):1623-1629
pubmed: 37355045
JAMA Intern Med. 2013 May 13;173(9):743-52
pubmed: 23546607
J Shoulder Elbow Surg. 2022 Jul;31(7):1436-1441
pubmed: 35176495
Clin Rheumatol. 2013 Jun;32(6):845-52
pubmed: 23443336
Best Pract Res Clin Rheumatol. 2016 Apr;30(2):279-295
pubmed: 27886800
J Arthroplasty. 2021 Oct;36(10):3534-3537
pubmed: 34176692
Respir Med. 2013 Mar;107(3):466-71
pubmed: 23266040
JAMA. 2012 Sep 26;308(12):1227-36
pubmed: 23011713
Dermatol Ther. 2020 Nov;33(6):e14063
pubmed: 32710599
Radiographics. 2002 Oct;22 Spec No:S215-30
pubmed: 12376612
Rev Infect Dis. 1989 Nov-Dec;11(6):954-63
pubmed: 2690289
Orthop J Sports Med. 2022 Mar 21;10(3):23259671221083586
pubmed: 35340726
Patient Saf Surg. 2017 May 11;11:15
pubmed: 28503200
Arthroplast Today. 2021 Sep 15;11:151-156
pubmed: 34584919
Arthritis Rheum. 2009 May 15;61(5):600-4
pubmed: 19405011