Background

Although previous studies evaluated postoperative outcomes of arthroplasty patients with chronic obstructive pulmonary disease (COPD), no meta-analysis has been conducted.

Methods

An electronic search was conducted on PubMed, Embase, and Cochrane Library databases to identify relevant studies published from inception to May 1, 2022. To assess the impact of COPD on postoperative outcomes, the odds ratios and 95% confidence intervals were calculated; pooled results were calculated using a random effects model. Sensitivity and subgroup analyses were carried out according to surgical type and statistical method. A total of 11 retrospective cohort studies involving patients with COPD who underwent hip or knee arthroplasties were included in the meta-analysis. There were 195,444 patients with COPD and 1,592,908 patients without COPD.

Results

A pooled analysis showed that the COPD group was at higher risk for mortality, readmission, pneumonia, sepsis, septic shock, and surgical site infection within 30 days following hip arthroplasties than the non-COPD group. Moreover, COPD patients were more likely to experience mortality, readmission, pneumonia, sepsis, septic shock, and surgical site infection 30 days after knee arthroplasties.

Conclusion

In this study, coexisting COPD was associated with worse outcomes in patients with lower extremity joint arthroplasties. The findings highlighted the importance of preoperative optimization and proactive interventions for COPD in the perioperative period.

中文翻译：

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慢性阻塞性肺病与接受髋关节或膝关节置换术的患者的严重感染和静脉血栓栓塞有关：观察性研究的荟萃分析

背景

尽管之前的研究评估了慢性阻塞性肺疾病 (COPD) 关节置换术患者的术后结果，但尚未进行荟萃分析。

方法

对 PubMed、Embase 和 Cochrane 图书馆数据库进行了电子搜索，以确定从开始到 2022 年 5 月 1 日发表的相关研究。为了评估 COPD 对术后结果的影响，计算了比值比和 95% 置信区间；使用随机效应模型计算汇总结果。根据手术类型和统计方法进行敏感性分析和亚组分析。共有 11 项涉及接受髋关节或膝关节置换术的 COPD 患者的回顾性队列研究被纳入荟萃分析。有 195,444 名 COPD 患者和 1,592,908 名非 COPD 患者。

结果

一项汇总分析显示，与非 COPD 组相比，COPD 组在髋关节置换术后 30 天内的死亡率、再入院、肺炎、败血症、败血性休克和手术部位感染的风险更高。此外，COPD 患者在膝关节置换术后 30 天更有可能出现死亡、再入院、肺炎、败血症、败血性休克和手术部位感染。

结论

在这项研究中，并存的 COPD 与下肢关节置换术患者的较差结果相关。研究结果强调了术前优化和围手术期 COPD 主动干预的重要性。