Abstract
Purpose
This study investigates the association between insulin-dependent and non-insulin-dependent diabetes and 30-day postoperative complications following aseptic revision total shoulder arthroplasty (TSA).
Methods
The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who underwent aseptic revision TSA from 2015 to 2021. The study population was divided into three groups based on diabetic status: nondiabetes, insulin-dependent diabetes, and non-insulin-dependent diabetes. Logistic regression analysis was conducted to investigate the relationship between diabetic status and postoperative complications.
Results
Compared to nondiabetes, insulin-dependent diabetes was independently associated with a significantly greater likelihood of experiencing any complication (OR 1.59, 95% CI 1.08–2.35; P = 0.020) and LOS > 2 days (OR 1.73, 95% CI 1.13–2.65; P = 0.012). Compared to nondiabetes, non-insulin-dependent diabetes was not independently associated with a significantly greater likelihood of experiencing complications. Preoperative insulin-dependent diabetic status was significantly associated with a greater rate of early postoperative complications following aseptic revision TSA, while preoperative non-insulin-dependent diabetic status was not.
Conclusion
Preoperative insulin-dependent diabetic status was significantly associated with a greater rate of early postoperative complications following aseptic revision TSA. A better understanding of the role diabetes, both insulin-dependent and non-insulin-dependent, as a risk factor may help physicians better risk stratify and select surgical candidates for revision TSA.
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Rachel A. Loyst, Steven H. Liu, and Patricia Cerri Droz. The first draft of the manuscript was written by Rachel A. Loyst, Steven H. Liu, and Patricia Cerri Droz. The manuscript was reviewed, edited, and revised critically by authors William Leatherwood, Edward D. Wang, and David E. Komatsu. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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Loyst, R.A., Liu, S.H., Cerri-Droz, P. et al. Role of insulin-dependent and non-insulin-dependent diabetes in aseptic revision total shoulder arthroplasty. Eur J Orthop Surg Traumatol (2024). https://doi.org/10.1007/s00590-024-03954-2
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DOI: https://doi.org/10.1007/s00590-024-03954-2