Anthony E Seddio, Jay Moran, Michael J Gouzoulis, Nickolas G Garbis, Dane H Salazar, Jonathan N Grauer, Andrew E Jimenez
{"title":"接受关节镜下肩袖修复术的 II 型糖尿病患者使用塞马鲁肽可降低术后并发症和肩袖再撕裂的风险。","authors":"Anthony E Seddio, Jay Moran, Michael J Gouzoulis, Nickolas G Garbis, Dane H Salazar, Jonathan N Grauer, Andrew E Jimenez","doi":"10.1016/j.arthro.2024.09.057","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the potential impact of preoperative semaglutide use (active agent in Ozempic® and Wegovy®) on ninety-day postoperative outcomes and two-year rotator cuff retear following arthroscopic rotator cuff repair (ARCR) for type II diabetes mellitus (T2DM) patients.</p><p><strong>Methods: </strong>T2DM patients undergoing primary ARCR were identified from the PearlDiver database using administrative billing codes. Exclusion criteria included: patients <18 years old, prior RCR, concurrent non-rotator cuff related arthroscopic shoulder procedures, any traumatic, neoplastic, or infectious diagnoses within 90-days before surgery, and <90-days follow-up. T2DM patients using semaglutide within one-year of ARCR ([+]semaglutide) were matched 1:4 with T2DM patients who did not ([-]semaglutide) by age, sex, Elixhauser Comorbidity Index (ECI), diabetes complications, obesity, tobacco, insulin, and metformin use. Occurrence of any, severe, and minor adverse events (AAE, SAEs, MAEs, respectively) within 90-days were compared by multivariable logistic regression. Two-year retear was assessed by Kaplan-Meier survival analysis and compared by log-rank test.</p><p><strong>Results: </strong>There were 1,094 ARCR (+)semaglutide and 4,110 ARCR (-)semaglutide patients meeting inclusion criteria after matching. The incidence of AAE for the ARCR (-)semaglutide vs. ARCR (+)semaglutide patients was 27.4% vs. 11.0%, SAE was 10.5% vs. 3.5%, and MAE was 22.0% vs. 8.5%, respectively (p<0.001 for all). ARCR (-)semaglutide patients had a higher odds ratio (OR) of AAE (3.65, p<0.001) and SAEs (3.62, p<0.001), including surgical-site infection (2.22, p=0.049), venous thromboembolism (3.10, p<0.001), sepsis (3.87, p<0.001), and cardiac events (3.96, p<0.001). Also, greater odds of MAEs (3.59, p<0.001), including urinary tract infection (3.27), pneumonia (3.88), acute kidney injury (3.91), and ED visits (2.51) (p<0.001 for all). Additionally, (-)semaglutide patients revealed higher 2-year retear vs (+)semaglutide patients (18.3% vs 12.5%, respectively) (p<0.001).</p><p><strong>Conclusion: </strong>Preoperative semaglutide use for T2DM patients undergoing ARCR was associated with decreased odds of minor and serious 90-day adverse events, and lower 2-year rotator cuff retear.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>","PeriodicalId":55459,"journal":{"name":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","volume":null,"pages":null},"PeriodicalIF":4.4000,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Lower Risk of Postoperative Complications and Rotator Cuff Retear Associated with Semaglutide Use in Patients with Type II Diabetes Mellitus Undergoing Arthroscopic Rotator Cuff Repair.\",\"authors\":\"Anthony E Seddio, Jay Moran, Michael J Gouzoulis, Nickolas G Garbis, Dane H Salazar, Jonathan N Grauer, Andrew E Jimenez\",\"doi\":\"10.1016/j.arthro.2024.09.057\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To investigate the potential impact of preoperative semaglutide use (active agent in Ozempic® and Wegovy®) on ninety-day postoperative outcomes and two-year rotator cuff retear following arthroscopic rotator cuff repair (ARCR) for type II diabetes mellitus (T2DM) patients.</p><p><strong>Methods: </strong>T2DM patients undergoing primary ARCR were identified from the PearlDiver database using administrative billing codes. Exclusion criteria included: patients <18 years old, prior RCR, concurrent non-rotator cuff related arthroscopic shoulder procedures, any traumatic, neoplastic, or infectious diagnoses within 90-days before surgery, and <90-days follow-up. T2DM patients using semaglutide within one-year of ARCR ([+]semaglutide) were matched 1:4 with T2DM patients who did not ([-]semaglutide) by age, sex, Elixhauser Comorbidity Index (ECI), diabetes complications, obesity, tobacco, insulin, and metformin use. Occurrence of any, severe, and minor adverse events (AAE, SAEs, MAEs, respectively) within 90-days were compared by multivariable logistic regression. Two-year retear was assessed by Kaplan-Meier survival analysis and compared by log-rank test.</p><p><strong>Results: </strong>There were 1,094 ARCR (+)semaglutide and 4,110 ARCR (-)semaglutide patients meeting inclusion criteria after matching. The incidence of AAE for the ARCR (-)semaglutide vs. ARCR (+)semaglutide patients was 27.4% vs. 11.0%, SAE was 10.5% vs. 3.5%, and MAE was 22.0% vs. 8.5%, respectively (p<0.001 for all). ARCR (-)semaglutide patients had a higher odds ratio (OR) of AAE (3.65, p<0.001) and SAEs (3.62, p<0.001), including surgical-site infection (2.22, p=0.049), venous thromboembolism (3.10, p<0.001), sepsis (3.87, p<0.001), and cardiac events (3.96, p<0.001). Also, greater odds of MAEs (3.59, p<0.001), including urinary tract infection (3.27), pneumonia (3.88), acute kidney injury (3.91), and ED visits (2.51) (p<0.001 for all). Additionally, (-)semaglutide patients revealed higher 2-year retear vs (+)semaglutide patients (18.3% vs 12.5%, respectively) (p<0.001).</p><p><strong>Conclusion: </strong>Preoperative semaglutide use for T2DM patients undergoing ARCR was associated with decreased odds of minor and serious 90-day adverse events, and lower 2-year rotator cuff retear.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study.</p>\",\"PeriodicalId\":55459,\"journal\":{\"name\":\"Arthroscopy-The Journal of Arthroscopic and Related Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.4000,\"publicationDate\":\"2024-10-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Arthroscopy-The Journal of Arthroscopic and Related Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.arthro.2024.09.057\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Arthroscopy-The Journal of Arthroscopic and Related Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.arthro.2024.09.057","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Lower Risk of Postoperative Complications and Rotator Cuff Retear Associated with Semaglutide Use in Patients with Type II Diabetes Mellitus Undergoing Arthroscopic Rotator Cuff Repair.
Purpose: To investigate the potential impact of preoperative semaglutide use (active agent in Ozempic® and Wegovy®) on ninety-day postoperative outcomes and two-year rotator cuff retear following arthroscopic rotator cuff repair (ARCR) for type II diabetes mellitus (T2DM) patients.
Methods: T2DM patients undergoing primary ARCR were identified from the PearlDiver database using administrative billing codes. Exclusion criteria included: patients <18 years old, prior RCR, concurrent non-rotator cuff related arthroscopic shoulder procedures, any traumatic, neoplastic, or infectious diagnoses within 90-days before surgery, and <90-days follow-up. T2DM patients using semaglutide within one-year of ARCR ([+]semaglutide) were matched 1:4 with T2DM patients who did not ([-]semaglutide) by age, sex, Elixhauser Comorbidity Index (ECI), diabetes complications, obesity, tobacco, insulin, and metformin use. Occurrence of any, severe, and minor adverse events (AAE, SAEs, MAEs, respectively) within 90-days were compared by multivariable logistic regression. Two-year retear was assessed by Kaplan-Meier survival analysis and compared by log-rank test.
Results: There were 1,094 ARCR (+)semaglutide and 4,110 ARCR (-)semaglutide patients meeting inclusion criteria after matching. The incidence of AAE for the ARCR (-)semaglutide vs. ARCR (+)semaglutide patients was 27.4% vs. 11.0%, SAE was 10.5% vs. 3.5%, and MAE was 22.0% vs. 8.5%, respectively (p<0.001 for all). ARCR (-)semaglutide patients had a higher odds ratio (OR) of AAE (3.65, p<0.001) and SAEs (3.62, p<0.001), including surgical-site infection (2.22, p=0.049), venous thromboembolism (3.10, p<0.001), sepsis (3.87, p<0.001), and cardiac events (3.96, p<0.001). Also, greater odds of MAEs (3.59, p<0.001), including urinary tract infection (3.27), pneumonia (3.88), acute kidney injury (3.91), and ED visits (2.51) (p<0.001 for all). Additionally, (-)semaglutide patients revealed higher 2-year retear vs (+)semaglutide patients (18.3% vs 12.5%, respectively) (p<0.001).
Conclusion: Preoperative semaglutide use for T2DM patients undergoing ARCR was associated with decreased odds of minor and serious 90-day adverse events, and lower 2-year rotator cuff retear.
Level of evidence: Level III, retrospective comparative study.
期刊介绍:
Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.