Investigation and characteristic analysis on comorbidities in elderly patients with total hip/knee arthroplasty_West China Medical Journal

Authors：

ZHANG Hongying ^1,2 ,  NING Ning ¹ ,  CHEN Jiali ¹ , LI Peifang ¹ , XIE Jingying ¹

1. West China School of Nursing, Sichuan University/Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Orthopedics, Second People’s Hospital of Deyang City, Deyang, Sichuan 618000, P. R. China;

Corresponding?author：

NING Ning, Email: gkningning@126.com; CHEN Jiali, Email: cjl85614115@163.com

Keywords：

Arthroplasty; Elderly patients; Comorbidities

DOI：

10.7507/1002-0179.202007265

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Objective To investigate and analyze comorbidities of elderly patients with total hip/knee arthroplasty, so as to provide a basis for the management of comorbidities.Methods Convenience sampling was used to select elderly patients who underwent total hip/knee arthroplasty in the Department of Orthopedics in West China Hospital of Sichuan University from June to December 2019 as the research objects. We collected general data and comorbidity data of patients, and statistically analyzed the comorbidities of elderly patients undergoing total hip/knee arthroplasty, and the characteristics of perioperative psychology, sleep, postoperative complications, and length of hospital stay in elderly patients undergoing total hip/knee arthroplasty with comorbidities.Results A total of 263 patients were included, of whom 64.6% had comorbidities. The number of comorbidities in elderly patients undergoing total hip/knee arthroplasty ranged from 2 to 12. The most common comorbidity was hypertension. Between patients with comorbidities and non-comorbidities, there were statistically significant differences in age (Z=?2.225, P=0.026), preoperative Huaxi Emotion Index scores (9.6±4.6 vs. 6.4±5.0; t=5.126, P<0.001), preoperative Pittsburgh Sleep Quality Index scores (13.3±3.1 vs. 12.3±2.5; t=?2.972, P=0.003), hospital stay [(5.2±0.8) vs. (4.8±0.4) d; t=4.243, P<0.001], and incidence of postoperative complications (13.5% vs. 5.4%; χ²=4.201, P=0.040).Conclusions Comorbidities are common in elderly patients with total hip/knee arthroplasty, which may aggravate negative emotions, reduce sleep quality, increase postoperative complications and prolong length of stay. Medical staff should strengthen the management of comorbidity in elderly patients with total hip/knee arthroplasty, so as to reduce its influence on perioperative period and promote the rehabilitation of patients.

Citation： ZHANG Hongying, NING Ning, CHEN Jiali, LI Peifang, XIE Jingying. Investigation and characteristic analysis on comorbidities in elderly patients with total hip/knee arthroplasty. West China Medical Journal, 2020, 35(10): 1195-1200. doi: 10.7507/1002-0179.202007265 Copy

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2.	van Steenbergen LN, Denissen GA, Spooren A, et al. More than 95% completeness of reported procedures in the population-based Dutch Arthroplasty Register. Acta Orthop, 2015, 86(4): 498-505.
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7.	Islam MM, Valderas JM, Yen L, et al. Multimorbidity and comorbidity of chronic diseases among the senior Australians: prevalence and patterns. PLoS One, 2014, 9(1): e83783.
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33.	de Jonge P, Roy JF, Saz P, et al. Prevalent and incident depression in community-dwelling elderly persons with diabetes mellitus: results from the ZARADEMP project. Diabetologia, 2006, 49(11): 2627-2633.
34.	Wallace K, Zhao X, Misra R, et al. The humanistic and economic burden associated with anxiety and depression among adults with comorbid diabetes and hypertension. J Diabetes Res, 2018, 2018: 4842520.
35.	王玉珠, 柳瑩, 李曉宇, 等. 關節置換患者圍手術期睡眠質量及影響因素研究. 中華骨與關節外科雜志, 2020, 13(4): 312-318.
36.	Horsten S, Reinke L, Absalom AR, et al. Systematic review of the effects of intensive-care-unit noise on sleep of healthy subjects and the critically ill. Br J Anaesth, 2018, 120(3): 443-452.
37.	王宗芳. 老年糖尿病患者睡眠質量現狀調查及其自我管理行為的相關性分析. 護理實踐與研究, 2019, 16(24): 14-16.
38.	郭建聯, 魏世超, 陳彥青, 等. 圍術期睡眠障礙的研究進展. 中華麻醉學雜志, 2019, 39(10): 1276-1280.
39.	羅政, 高艷紅, 皮紅英. 老年慢性阻塞性肺疾病患者睡眠質量及相關影響因素分析. 解放軍醫學院學報, 2019, 40(6): 509-512.
40.	Khanijow V, Prakash P, Emsellem HA, et al. Sleep dysfunction and gastrointestinal diseases. Gastroenterol Hepatol (N Y), 2015, 11(12): 817-825.
41.	雷建國, 陳善萍, 楊永學. 衰弱與老年人腹腔鏡術后快速康復相關性探討. 中華老年醫學雜志, 2018, 37(1): 62-66.
42.	張微微, 孟慧杰, 謝吉科, 等. 210例老年擇期手術患者術前用藥情況評價及藥物重整. 中國藥房, 2019, 30(1): 110-114.
43.	馬俊, 沈彬, 楊靜, 等. 人工全髖關節置換術后下肢深靜脈血栓形成的危險因素分析. 中國矯形外科雜志, 2009, 17(13): 965-969.
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1. Stewart SP. Joint replacement and rapid mobilization: a clinical perspective on rapid arthroplasty mobilization protocol. Orthop Nurs, 2012, 31(4): 224-229.
2. van Steenbergen LN, Denissen GA, Spooren A, et al. More than 95% completeness of reported procedures in the population-based Dutch Arthroplasty Register. Acta Orthop, 2015, 86(4): 498-505.
3. 尹志強, 潘惟麗, 金昊, 等. 骨性關節炎病因的研究進展. 現代生物醫學進展, 2016, 16(7): 1369-1371, 1389.
4. 彭晨健. 老年髖膝骨關節炎患者關節置換術后并發癥發生的影響因素分析. 南京: 南京中醫藥大學, 2019: 55.
5. 付麗英. 社區老年人慢性病共病及其對衛生服務利用的影響. 開封: 河南大學, 2019: 86.
6. van den Bussche H, Koller D, Kolonko T, et al. Which chronic diseases and disease combinations are specific to multimorbidity in the elderly? Results of a claims data based cross-sectional study in Germany. BMC Public Health, 2011, 11: 101.
7. Islam MM, Valderas JM, Yen L, et al. Multimorbidity and comorbidity of chronic diseases among the senior Australians: prevalence and patterns. PLoS One, 2014, 9(1): e83783.
8. 范利. 我國老年人慢性病防控迫在眉睫. 中國臨床保健雜志, 2019, 22(4): 433-434.
9. 趙明中, 胡大一, 彭曉霞. 老年患者共病及其管理. 中華老年醫學雜志, 2015, 34(12): 1364-1367.
10. Ferner RE, Aronson JK. Communicating information about drug safety. BMJ, 2006, 333(7559): 143-145.
11. 陳佳麗, 寧寧, 屈俊宏, 等. 骨科加速康復外科新視角. 華西醫學, 2018, 33(9): 1068-1072.
12. 中華醫學會骨科學分會. 中國骨科大手術靜脈血栓栓塞癥預防指南. 中華骨科雜志, 2016(2): 65-71.
13. 徐倩. 老年住院患者共病與多重用藥的分析. 昆明: 昆明醫科大學, 2017: 44.
14. 代明彬, 呂洋. 老年人合理用藥策略的研究進展. 中華老年醫學雜志, 2016, 35(1): 100-104.
15. 劉珊珊, 鄭儒君, 李俊英, 等. 華西心晴指數在腫瘤科護士心理狀況測定中的應用. 四川醫學, 2017, 38(11): 1330-1335.
16. 孟憲東, 高猛, 李濤, 等. 華西心情指數量表在護理人員中應用的信度與效度研究. 中國護理管理, 2017, 17(3): 310-312.
17. 路桃影, 李艷, 夏萍, 等. 匹茲堡睡眠質量指數的信度及效度分析. 重慶醫學, 2014(3): 260-263.
18. 彭志鵬, 張星平, 陳俊逾, 等. 基于匹茲堡睡眠質量指數的脾不藏意型及腎不藏志型不寐患者睡眠質量比較的臨床研究. 上海中醫藥雜志, 2020, 54(4): 65-67.
19. 趙瑞敏. 某院住院患者多病共存情況調查分析. 太原: 山西醫科大學, 2016: 37.
20. 閆巍, 李瑞, 王杰萍, 等. 北京市某三級醫院綜合科老年共病住院患者臨床特點分析. 中國全科醫學, 2018, 21(14): 1648-1656.
21. 崔娟, 毛凡, 王志會. 中國老年居民多種慢性病共存狀況分析. 中國公共衛生, 2016, 32(1): 66-69.
22. 陳建民, 賈小寶, 鮑磊, 等. 全髖關節置換術后傷口延遲愈合與高血壓的相關性研究. 中國矯形外科雜志, 2017, 25(10): 865-869.
23. 常承婷, 寧寧. 全髖關節置換術外科傷口感染的危險因素研究進展. 華西醫學, 2019, 34(9): 1059-1062.
24. 劉春, 錢志剛, 孫啟才. 腰椎滑脫癥術后傷口感染危險因素分析. 中國骨傷, 2019, 32(10): 882-885.
25. 焦申軍, 耿麗娟. 老年患者多藥共用的原因及管理對策. 中國當代醫藥, 2018, 25(31): 171-173.
26. 李旭, 于軍. 老年人合理用藥分析. 中國老年學雜志, 2019, 39(7): 1789-1791.
27. 周雙, 向倩. 系列問答142—為什么非甾體類抗炎藥與抗凝藥聯合應用有潛在風險?. 藥物不良反應雜志, 2018, 20(5): 400.
28. Wong SY, Mercer SW, Woo J, et al. The influence of multi-morbidity and self-reported socio-economic standing on the prevalence of depression in an elderly Hong Kong population. BMC Public Health, 2008, 8: 119.
29. Gahlan D, Rajput R, Gehlawat P, et al. Prevalence and determinants of diabetes distress in patients of diabetes mellitus in a tertiary care centre. Diabetes Metab Syndr, 2018, 12(3): 333-336.
30. 張晨, 宋國瑞, 劉子歌, 等. ERAS在老年人工關節置換術中的應用進展. 寧夏醫科大學學報, 2020, 42(2): 211-214.
31. H?fner S, Baumert J, Emeny RT, et al. Hypertension and depressed symptomatology: a cluster related to the activation of the renin-angiotensin-aldosterone system (RAAS). Findings from population based KORA F4 study. Psychoneuroendocrinology, 2013, 38(10): 2065-2074.
32. Maraldi C, Volpato S, Penninx BW, et al. Diabetes mellitus, glycemic control, and incident depressive symptoms among 70- to 79-year-old persons: the health, aging, and body composition study. Arch Intern Med, 2007, 167(11): 1137-1144.
33. de Jonge P, Roy JF, Saz P, et al. Prevalent and incident depression in community-dwelling elderly persons with diabetes mellitus: results from the ZARADEMP project. Diabetologia, 2006, 49(11): 2627-2633.
34. Wallace K, Zhao X, Misra R, et al. The humanistic and economic burden associated with anxiety and depression among adults with comorbid diabetes and hypertension. J Diabetes Res, 2018, 2018: 4842520.
35. 王玉珠, 柳瑩, 李曉宇, 等. 關節置換患者圍手術期睡眠質量及影響因素研究. 中華骨與關節外科雜志, 2020, 13(4): 312-318.
36. Horsten S, Reinke L, Absalom AR, et al. Systematic review of the effects of intensive-care-unit noise on sleep of healthy subjects and the critically ill. Br J Anaesth, 2018, 120(3): 443-452.
37. 王宗芳. 老年糖尿病患者睡眠質量現狀調查及其自我管理行為的相關性分析. 護理實踐與研究, 2019, 16(24): 14-16.
38. 郭建聯, 魏世超, 陳彥青, 等. 圍術期睡眠障礙的研究進展. 中華麻醉學雜志, 2019, 39(10): 1276-1280.
39. 羅政, 高艷紅, 皮紅英. 老年慢性阻塞性肺疾病患者睡眠質量及相關影響因素分析. 解放軍醫學院學報, 2019, 40(6): 509-512.
40. Khanijow V, Prakash P, Emsellem HA, et al. Sleep dysfunction and gastrointestinal diseases. Gastroenterol Hepatol (N Y), 2015, 11(12): 817-825.
41. 雷建國, 陳善萍, 楊永學. 衰弱與老年人腹腔鏡術后快速康復相關性探討. 中華老年醫學雜志, 2018, 37(1): 62-66.
42. 張微微, 孟慧杰, 謝吉科, 等. 210例老年擇期手術患者術前用藥情況評價及藥物重整. 中國藥房, 2019, 30(1): 110-114.
43. 馬俊, 沈彬, 楊靜, 等. 人工全髖關節置換術后下肢深靜脈血栓形成的危險因素分析. 中國矯形外科雜志, 2009, 17(13): 965-969.
44. 徐建圓, 鈄曉帆, 余雙娟. 老年髖部骨折圍手術期深靜脈血栓形成影響因素分析. 浙江創傷外科, 2020, 25(1): 115-116.
45. 彭浩, 梁篤, 李保林, 等. 查爾森合并癥指數與老年股骨轉子間骨折住院時間及費用的相關性研究. 中醫藥臨床雜志, 2019, 31(5): 995-997.
46. Nikkel LE, Fox EJ, Black KP, et al. Impact of comorbidities on hospitalization costs following hip fracture. J Bone Joint Surg Am, 2012, 94(1): 9-17.
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Investigation and characteristic analysis on comorbidities in elderly patients with total hip/knee arthroplasty

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