Perioperative hyperglycaemia and incidence of post-operative complications in patients undergoing total knee arthroplasty

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• 作者：Diego Reátegui ; Gerard Sanchez-Etayo…
• 关键词：Total knee arthroplasty ; Diabetes mellitus ; Hyperglycaemia ; Complications
• 刊名：Knee Surgery, Sports Traumatology, Arthroscopy
• 出版年：2015
• 出版时间：July 2015
• 年：2015
• 卷：23
• 期：7
• 页码：2026-2031
• 全文大小：488 KB
• 参考文献：1.Agus MSD, Steil GM, Wypij D et al (2012) Tight glycemic control versus standard care after pediatric cardiac surgery. N Engl J Med 367:1208-219PubMed Central PubMed View Article
  2.Allepuz A, Serra-Sutton V, Espallargues M, Salvador X, Pons JM (2008) Hip and knee arthroplasties in Catalonia [Spain] from 1994 to 2005. Gac Sanit 22(6):534-40PubMed View Article
  3.American Diabetes Association (2013) Diagnosis and classification of diabetes mellitus. Diab Care 36(1):s67–s74View Article
  4.Ata A, Lee J, Bestle SL, Desemone J, Stain SC (2010) Postoperative hyperglycemia and surgical site infection in general surgery patients. Arch Surg 145(9):858-64PubMed View Article
  5.Bolognesi MP, Marchant MH Jr, Viens NA, Cook C, Pietrobon R, Vail TP (2008) The impact of diabetes on perioperative patient outcomes after total hip and total knee arthroplasty in the United States. J Arthroplasty 23(6 Suppl 1):92-8PubMed View Article
  6.Jamsem E, Nevalainen P, Kalliavolkama J, Moilanen T (2010) Preoperative hyperglycemia predicts infected total knee replacement. Eur J Int Med 21(3):196-01View Article
  7.Gandhi GY, Murad MH, Flynn DN, Erwin PJ, Cavalcante AB, Bay Nielsen H, Capes SE, Thorlund K, Montori VM, Devereaux PJ (2008) Effect of perioperative insulin infusion on surgical morbidity and mortality: systematic review and meta-analysis of randomized trials. Mayo Clin Proc 83(4):418-30PubMed View Article
  8.Gandhi R, Razak F, Davey JR, Mahomed NN (2010) Metabolic syndrome and the functional outcomes of hip and knee arthroplasty. J Rheumatol 37(9):1917-922PubMed View Article
  9.Iorio R, Williams KM, Marcantonio AJ, Specht LM, Tilzey JF, Healy WL (2012) Diabetes mellitus, hemoglobin A1C, and the incidence of total joint arthroplasty infection. J Arthroplasty 27(5):726-29PubMed View Article
  10.Jain NB, Higgins LD, Ozumba D, Guller U, Cronin M, Pietrobon R, Katz JN (2005) Trends?in?epidemiology?of knee arthroplasty in the United States, 1990-000. Arthritis Rheum 52(12):3928-933PubMed View Article
  11.Kerkhoffs GMMJ, Servien E, Dunn W, Dahm D, Bramer JAM, Haverkamp D (2012) The influence of obesity on the complication rate and outcome of total knee arthroplasty: a meta-analysis and systematic literature review. J Bone Joint Surg Am 5:1839-844. doi:10.-106/?JBJS.?K.-0820 View Article
  12.Kurtz S, Ong K, Lau E, Mowat F, Halpern M (2007) Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 89(4):780-85PubMed View Article
  13.Lai K, Bohm ER, Burnell C, Hedden DR (2007) Presence of medical comorbidities in patients with infected primary hip or knee arthroplasties. J Arthroplasty 22:651-56PubMed View Article
  14.Leibowitz G, Raizman E, Brezis M, Glaser B, Raz I, Shapira O (2010) Effects of moderate intensity glycemic control after cardiac surgery. Ann Thorac Surg 90:1825-832PubMed View Article
  15.Liu SS, Della Valle AG, Besculides MC, Gaber LK, Memtsoudis SG (2009) Trends in mortality, complications, and demographics for primary hip arthroplasty in the United States. Int Orthop 33(3):643-51PubMed Central PubMed View Article
  16.Malinzak RA, Ritter MA, Berend ME, Meding JB, Olberding EM, Davis KE (2009) Morbidly obese, diabetic, younger, and unilateral joint arthroplasty patients have elevated total joint arthroplasty infection rates. J Arthroplasty 24:84-8PubMed View Article
  17.Marchant MH Jr, Viens NA, Cook C, Vail TP, Bolognesi MP (2009) The impact of glycemic control and diabetes mellitus on perioperative outcomes after total joint arthroplasty. J Bone Joint Surg Am 91:1621-629PubMed View Article
  18.Martinez-Huedo MA, Villanueva M, de Andres AL, Hernandez-Barrera V, Carrasco-Garrido P, Gil A, Martinez D, Jiménez-Garcia R (2013) Trends 2001 to 2008 in incidence and immediate postoperative outcomes for major joint replacement among Spanish adults suffering diabetes. Eur J Orthop Surg Traumatol 23(1):53-9PubMed View Article
  19.McConnell YJ, Johnson PM, Porter GA (2009) Surgical site infections following colorectal surgery in patients with diabetes: association with postoperative hyperglycemia. J Gastrointest Surg 13(3):508-15PubMed View Article
  20.Memtsoudis SG, Della Valle AG, Besculides MC, Gaber L, Laskin R (2009) Trends?in demographics, comorbidity profiles, in-hospital complications and mortality associated with primary knee arthroplasty. J Arthroplasty 24(4):518-27PubMed View Article
  21.Moon HK, Han CD, Yang IH, Cha BS (2008) Factors affecting outcome after total knee arthroplasty in patients with diabetes mellitus. Yonsei Med J 49(1):129-37PubMed Central PubMed View Article
  22.Mraovic B, Donghun S, Jacovides C, Parvizi J (2011) Perioperative hyperglycemia and postoperative infection after lower limb arthroplasty. J Diab Sci Technol 5:413-18
  23.Olsen MA, Nepple JJ, Riew KD, Lenke LG, Bridwell KH, Mayfield J, Fraser VJ (2008) Risk factors for surgical site infection
• 作者单位：Diego Reátegui (1)
  Gerard Sanchez-Etayo (2)
  Esther Nú?ez (3)
  Monserrat Tió (2)
  Dragos Popescu (4)
  Monserrat Nú?ez (5)
  Luis Lozano (4)
  
  1. Trauma and Orthopedics Department, Hospital Clinic, Barcelona, Spain
  2. Anesthesiologic Department, Hospital Clinic, Barcelona, Spain
  3. Institut Català de la Salut, Barcelona, Spain
  4. Knee Unit, Trauma and Orthopedics Department, Hospital Clinic, Barcelona, Spain
  5. Reumathology Department, Hospital Clinic, Barcelona, Spain
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Orthopedics
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1433-7347

文摘

Purpose The aim of this study was to assess whether hyperglycaemia in the post-operative period of total knee arthroplasty (TKA) affects post-operative complications regardless of diabetes mellitus (DM) diagnosis. Methods All patients who had undergone primary TKA were included in the study. The following data were recorded: DM diagnosis, and pre- (BGL1), intra- (BGL2) and post-operative blood glucose levels (BGL3). After 1-year follow-up, medical, infectious and mechanical or surgery-related complications were recorded. Results Of the 833 patients included, 130 (15.6?%) were diabetic. Median BGL1, BGL2 and BGL3 were 106.13, 93.49 and 134.16?mg/dl, respectively. After follow-up, 173 (20.8?%) patients presented complications, including 48 (5.76?%) medical complications and 94 (11.28?%) infections. Surgery-related complications presented in 31 (3.72?%) patients. A statistically significant association was found between BGL3?≥?26?mg/dl and complications (OR 1.95, p?<?0.001), medical complications (OR 3.98, p?<?0.001), and infections (OR 1.76, p?<?0.006). Conclusions Hyperglycaemia during the post-operative period in diabetic and non-diabetic patients undergoing TKA increases post-operative medical and infectious complications. Glycemic control during this period must be performed in order to reduce these complications. Level of evidence Retrospective case series, Level IV.