Smoking is associated with higher short-term risk of revision and mortality following primary hip or knee arthroplasty: a cohort study of 272,640 patients from the Dutch Arthroplasty Registry.

Autor:	Bongers J; Department of Orthopaedic Surgery, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen; Department of Orthopaedic Surgery, Sint Maartenskliniek, Nijmegen; Department of Orthopaedic Surgery, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands. joris.bongers1@gmail.com., Belt M; Department of Research and Innovation, Sint Maartenskliniek, Nijmegen., Spekenbrink-Spooren A; Dutch Arthroplasty Register (Landelijke Registratie Orthopedische Interventies), 's-Hertogenbosch., Smulders K; Department of Research and Innovation, Sint Maartenskliniek, Nijmegen., Schreurs BW; Department of Orthopaedic Surgery, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen; Dutch Arthroplasty Register (Landelijke Registratie Orthopedische Interventies), 's-Hertogenbosch., Koeter S; Department of Orthopaedic Surgery, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands.
Jazyk:	angličtina
Zdroj:	Acta orthopaedica [Acta Orthop] 2024 Feb 12; Vol. 95, pp. 114-120. Date of Electronic Publication: 2024 Feb 12.
DOI:	10.2340/17453674.2024.39966
Abstrakt:	Background and Purpose: Patients actively smoking at the time of primary hip or knee arthroplasty are at increased risk of direct perioperative complications. We investigated the association between smoking status and risk of revision and mortality within 2 years following hip or knee arthroplasty. Methods: We used prospectively collected data from the Dutch Arthroplasty Register. All primary total hip arthroplasties (THAs), total knee arthroplasties (TKAs), and unicondylar knee arthroplasties (UKAs) with > 2 years' follow-up were included (THA: n = 140,336; TKA: n = 117,497; UKA: n = 14,807). We performed multivariable Cox regression analyses to calculate hazard risks for differences between smokers and non-smokers, while adjusting for confounders (aHR). Results: The smoking group had higher risk of revision (THA: aHR 1.3, 95% confidence interval [CI] 1.1-1.4 and TKA: aHR 1.4, CI 1.3-1.6) and risk of mortality (THA: aHR 1.4, CI 1.3-1.6 and TKA: aHR 1.4, CI 1.2-1.6). Following UKA, smokers had a higher risk of mortality (aHR 1.7, CI 1.0-2.8), but no differences in risk of revision were observed. The smoking group had a higher risk of revision for infection following TKA (aHR 1.3, CI 1.0-1.6), but not following THA (aHR 1.0, CI 0.8-1.2). Conclusion: This study showed that the risk of revision and mortality is higher for smokers than for non-smokers in the first 2 years following THA and TKA. Smoking could contribute to complications following primary hip or knee arthroplasty.
Databáze:	MEDLINE
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