THURSDAY, July 9 (HealthDay News) -- Patients with uncontrolled diabetes are at higher risk of complications and mortality after knee or hip total joint arthroplasty than patients with controlled diabetes, according to research published in the July 1 Journal of Bone & Joint Surgery.
Milford H. Marchant Jr., M.D., of Duke University Medical Center in Durham, N.C., and colleagues analyzed data from the Nationwide Inpatient Sample on more than one million patients undergoing knee or hip replacement surgery between 1988 and 2005.
The researchers found that patients with uncontrolled diabetes, compared to controlled disease, had higher risk of stroke (adjusted odds ratio, 3.42), postoperative hemorrhage (adjusted odds ratio, 1.99), wound infection (adjusted odds ratio, 2.28), and death (adjusted odds ratio, 3.23), as well as a significantly longer stay. The authors further note that patients with diabetes, either controlled or uncontrolled, had higher inflation-adjusted postoperative charges than patients without diabetes.
"The results confirm our hypothesis that, regardless of diabetes type, patients with uncontrolled diabetes demonstrate significantly more perioperative complications as compared with patients with controlled diabetes or patients without diabetes," the authors write. "In a direct comparison between patients with uncontrolled and controlled diabetes with use of adjusted regression modeling, patients with uncontrolled disease clearly had a significantly greater propensity for systemic complications, death, and a longer length of stay."
Duke University Medical Center receives unrestricted institutional support from Zimmer and DePuy.
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