PMID- 28735804
OWN - NLM
STAT- MEDLINE
DCOM- 20180612
LR  - 20180702
IS  - 1532-8406 (Electronic)
IS  - 0883-5403 (Linking)
VI  - 32
IP  - 12
DP  - 2017 Dec
TI  - Effect of Type 2 Diabetes on In-Hospital Postoperative Complications and 
      Mortality After Primary Total Hip and Knee Arthroplasty.
PG  - 3729-3734.e2
LID - S0883-5403(17)30567-3 [pii]
LID - 10.1016/j.arth.2017.06.038 [doi]
AB  - BACKGROUND: We aimed to compare in-hospital postoperative complications (IHPC) 
      and in-hospital mortality between patients with and without type 2 diabetes 
      mellitus (T2DM) undergoing primary total hip arthroplasty (THA) and total knee 
      arthroplasty (TKA). METHODS: We analyzed data from the Spanish National Hospital 
      Discharge Database, 2010-2014. We selected patients who had undergone THA 
      (International Classification of Diseases, Ninth Revision, Clinical Modification 
      [ICD-9-CM] code 81.51) and TKA (code 81.54). Diabetic patients with THA and TKA 
      were matched by year, age, sex, and the comorbidities included in the modified 
      Elixhauser Comorbidity Index with a nondiabetic patient. RESULTS: We identified 
      115,234 THA patients and 195,355 TKA patients, 12.4% and 15.6% with T2DM, 
      respectively. We matched 10,777 and 26,640 pairs of diabetic and nondiabetic 
      patients. In T2DM patients who had undergone THA, the incidence of urinary tract 
      infection was higher than in nondiabetic patients (1.50% vs 1.09%, P = .007), as 
      was that of "any IHPC" (9.68% vs 8.98%, P = .038). In patients who had undergone 
      TKA, the incidence of postoperative anemia was significantly higher in diabetic 
      patients (4.90% vs 4.53, P = .040), as was that of urinary tract infection (0.80% 
      vs 0.53%, P = .025) and "any IHPC" (7.30% vs 6.76%, P = .014). In both 
      procedures, mean length of hospital stay was significantly higher in diabetic 
      patients; for TKA, in-hospital mortality was higher in diabetic patients (0.09% 
      vs 0.02%, P = .002). Previous comorbidities, age, and obesity predict a higher 
      incidence of IHPC among diabetic patients. CONCLUSIONS: This study confirms the 
      higher risk of IHPC among T2DM patients after joint arthroplasty. IHPC may result 
      in a higher risk of mortality in patients undergoing TKA.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Martinez-Huedo, Maria A
AU  - Martinez-Huedo MA
AD  - Department of Preventive Medicine, Hospital la Paz, Madrid, Spain.
FAU - Jimenez-Garcia, Rodrigo
AU  - Jimenez-Garcia R
AD  - Preventive Medicine and Public Health Unit, Universidad Rey Juan Carlos, 
      Alcorcon, Madrid, Spain.
FAU - Jimenez-Trujillo, Isabel
AU  - Jimenez-Trujillo I
AD  - Preventive Medicine and Public Health Unit, Universidad Rey Juan Carlos, 
      Alcorcon, Madrid, Spain.
FAU - Hernandez-Barrera, Valentin
AU  - Hernandez-Barrera V
AD  - Preventive Medicine and Public Health Unit, Universidad Rey Juan Carlos, 
      Alcorcon, Madrid, Spain.
FAU - Del Rio Lopez, Benito
AU  - Del Rio Lopez B
AD  - Escuela Tecnica Superior de Ingenieros Industriales, Madrid, Spain.
FAU - Lopez-de-Andres, Ana
AU  - Lopez-de-Andres A
AD  - Preventive Medicine and Public Health Unit, Universidad Rey Juan Carlos, 
      Alcorcon, Madrid, Spain.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20170705
PL  - United States
TA  - J Arthroplasty
JT  - The Journal of arthroplasty
JID - 8703515
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Arthroplasty, Replacement, Hip/*adverse effects/mortality
MH  - Arthroplasty, Replacement, Knee/*adverse effects/mortality
MH  - Comorbidity
MH  - Diabetes Mellitus, Type 2/*complications/surgery
MH  - Female
MH  - Hospital Mortality
MH  - Humans
MH  - Incidence
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Obesity/complications
MH  - Patient Discharge
MH  - Postoperative Complications/*epidemiology/mortality
MH  - Urinary Tract Infections/epidemiology
OTO - NOTNLM
OT  - complications
OT  - diabetes
OT  - mortality
OT  - total hip arthroplasty
OT  - total knee arthroplasty
EDAT- 2017/07/25 06:00
MHDA- 2018/06/13 06:00
CRDT- 2017/07/25 06:00
PHST- 2017/03/06 00:00 [received]
PHST- 2017/06/02 00:00 [revised]
PHST- 2017/06/24 00:00 [accepted]
PHST- 2017/07/25 06:00 [pubmed]
PHST- 2018/06/13 06:00 [medline]
PHST- 2017/07/25 06:00 [entrez]
AID - S0883-5403(17)30567-3 [pii]
AID - 10.1016/j.arth.2017.06.038 [doi]
PST - ppublish
SO  - J Arthroplasty. 2017 Dec;32(12):3729-3734.e2. doi: 10.1016/j.arth.2017.06.038. 
      Epub 2017 Jul 5.