在美国，有和没有糖尿病的80多岁老人初次全肩关节置换术后的发病率和死亡率的比较

Q2 Medicine

Journal of Clinical Orthopaedics and Trauma Pub Date : 2025-04-24 DOI:10.1016/j.jcot.2025.103027

Theodore Quan , Jeffrey Y. Wang , Philip M. Parel , Joseph E. Manzi , Benjamin J. Farley , Sean A. Tabaie , Zachary R. Zimmer

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引用次数: 0

摘要

背景：糖尿病患者在各种骨科手术中面临较高的术后并发症和手术问题风险。了解这些风险在老年人群中是否不同是至关重要的。因此，本研究旨在评估原发性全肩关节置换术（TSA）后，糖尿病80岁老人与非糖尿病80岁老人相比，30天的发病率和死亡率风险是否升高。方法数据来源于美国外科医师学会国家手术质量改进计划（ACS-NSQIP）数据库。2006年至2019年接受原发性TSA的80多岁老人分为糖尿病组和非糖尿病组。收集两组患者的人口统计信息、附加医疗条件和术后并发症，并采用单变量统计和多变量logistic回归分析。结果在对多个变量进行调整后，80多岁的糖尿病患者出血需要输血的风险更高(OR 1.52；p = 0.032)和延长住院时间(OR 1.41；P = 0.001)。两个队列的死亡率无显著差异（p = 0.173）。结论：对于80多岁的糖尿病患者来说，初级TSA似乎是一种安全的手术，尽管与非糖尿病患者相比，这些患者的输血风险增加，住院时间延长。证据水平ii。

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Comparative morbidity and mortality following primary total shoulder arthroplasty in octogenarians with and without diabetes in the United States

Background

Diabetic patients face higher risks of postoperative medical complications and surgical issues in various orthopedic surgeries. It is essential to understand if these risks differ in the older geriatric population. Therefore, this study sought to assess whether diabetic octogenarians exhibit elevated thirty-day morbidity and mortality risks in comparison to non-diabetic octogenarians after primary total shoulder arthroplasty (TSA).

Methods

Data were obtained from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Octogenarians who received primary TSA from 2006 to 2019 were categorized into diabetic and non-diabetic groups. Demographic information, additional medical conditions, and postoperative complications were gathered and analyzed between the two groups using both univariate statistics and multivariate logistic regression.

Results

After adjusting for multiple variables, diabetic octogenarians exhibited a higher risk of bleeding requiring blood transfusions (OR 1.52; p = 0.032) and prolonged hospital stays (OR 1.41; p = 0.001) compared to their non-diabetic counterparts. No significant difference in mortality rates was observed between the two cohorts (p = 0.173).

Conclusion

Primary TSA appears to be a generally safe procedure for diabetic octogenarians, though these patients demonstrate increased risks for blood transfusions and prolonged hospital stays compared to non-diabetes.

Level of evidence

III.

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来源期刊

Journal of Clinical Orthopaedics and Trauma Medicine-Orthopedics and Sports Medicine

CiteScore

4.30

自引率

0.00%

发文量

181

审稿时长

92 days

期刊介绍： Journal of Clinical Orthopaedics and Trauma (JCOT) aims to provide its readers with the latest clinical and basic research, and informed opinions that shape today''s orthopedic practice, thereby providing an opportunity to practice evidence-based medicine. With contributions from leading clinicians and researchers around the world, we aim to be the premier journal providing an international perspective advancing knowledge of the musculoskeletal system. JCOT publishes content of value to both general orthopedic practitioners and specialists on all aspects of musculoskeletal research, diagnoses, and treatment. We accept following types of articles: • Original articles focusing on current clinical issues. • Review articles with learning value for professionals as well as students. • Research articles providing the latest in basic biological or engineering research on musculoskeletal diseases. • Regular columns by experts discussing issues affecting the field of orthopedics. • "Symposia" devoted to a single topic offering the general reader an overview of a field, but providing the specialist current in-depth information. • Video of any orthopedic surgery which is innovative and adds to present concepts. • Articles emphasizing or demonstrating a new clinical sign in the art of patient examination is also considered for publication. Contributions from anywhere in the world are welcome and considered on their merits.