고관절 골관절염 환자에서 비만도가 인공 고관절치환술 직후 합병증 발생에 미치는 영향
Obesity and Perioperative Morbidity after Total Hip Arthroplasty inOsteoarthritis Patients
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목적: 비만도가 심한 고관절 골관절염 환자에서 인공 고관절 치환술 시행 직후 합병증 발생에 미치는 영향을 알아보고자 하였다. 대상 및 방법: 1987년 4월부터 2007년 4월까지 심한 고관절 골관절염으로 인공 고관절 치환술을 시행 받은 272명의 환자들 을 대상으로 체질량지수가 25 kg/m2 이상이었던 117명의 환자를 비만군, 체질량지수가 25 kg/m2 미만이었던 155명의 환자를 대조군으로 설정하고 후향적인 의무 기록 검토를 시행하여 두 군에서 재원 일수, 수술 시간, 실혈양 및 수혈양을 조사하였고 합 병증의 발생 빈도를 수술 합병증 및 내과적 합병증으로 나누어 비교하였다. 결과: 재원 기간, 수술 시간, 실혈양 및 수혈양은 모두 비만군과 대조군에서 통계학적인 차이를 보이지 않았다(p>0.05). 합병증 의 발생 빈도에 있어서는 수술 합병증의 발생 빈도는 두 군에서 유의한 차이가 없었으나(p>0.05) 내과적 합병증의 발생 빈도는 비만군에서 유의하게 높게 나타났다(p<0.05). 결론: 비만 환자군에서 심한 고관절 골관절염으로 인공 고관절 치환술을 시행한 후 재원 기간, 수술 시간, 실혈양과 수혈양 및 수술 합병증의 발생 빈도는 대조군과 비교하여 차이가 없었으나 내과적 합병증의 발생 빈도는 높게 나타났다.
Abstract
Purpose: To evaluate the effect of obesity on perioperative morbidity following total hip arthroplasty in patients with severe osteoarthritis. Materials and Methods: Between April 1987 and April 2007, 272 patients with severe osteoarthritis underwent total hip arthroplasty. One hundred seventeen patients were obese (body mass index, BMI≥25 kg/m2), and 155 were not obese (BMI<25 kg/m2). Through retrospective medical record research we were able to determine length of hospital stay, operation time, total blood loss and replacement, and surgical and medical complication rates for the two groups. Results: The obese and non-obese groups were similar in terms of length of hospital stay, operation time, total blood loss and replacement, and surgical complication rate (p>0.05). However, the medical complication rate was significantly higher in the obese group compared to the non-obese group (4.3% vs. 0.6%, p<0.005). Conclusion: In severe osteoarthritis patients undergoing total hip arthroplasty, obesity (BMI≥25 kg/m2) has no observable effect on perioperative morbidity in terms of length of hospital stay, operation time, total blood loss and replacement, or surgical complication rate, but is associated with a higher medical complication rate.
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