Work

Diabetes mellitus as a risk factor for postoperative complications following arthroscopic rotator cuff repair

Year: 2023

Type: article

Abstract: Background Patients with diabetes mellitus who undergo arthroscopic rotator cuff repair (aRCR) have an increased risk of postoperative complications when compared to nondiabetics. To further investigate these complications, we used a large national database to determine the 30-day postoperative complications associated with insulin-dependent and non-insulin-dependent diabetics following aRCR. Methods The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for all patients who underwent aRCR between 2015 and 2020. The study population was categorized into cohorts based on diabetes mellitus status: non-insulin-dependent diabetes mellitus (NIDDM), insulin-dependent diabetes mellitus (IDDM), and no diabetes. Multivariate analysis, adjusted for confounding demographics and comorbidities, was used to determine independently associated complications. Results There were 39,877 cases of aRCR in NQSIP included in this study. Diabetics comprised 6575 (16.7%) of these cases, with 4758 being NIDDM (11.9%) and 1817 being IDDM (4.6%). Bivariate logistic regression found both NIDDM and IDDM cohorts to be significantly associated with higher body mass index, ASA class ≥3, hypertension, chronic obstructive pulmonary disease, bleeding disorders, and preoperative wounds or infection ( P < .001). NIDDM was an independently associated risk factor for sepsis (odds ratio [OR], 2.77; 95% confidence interval [CI]: 1.01-7.58; P = .047). IDDM was an independently associated risk factor for pneumonia (OR, 2.49; 95% CI: 1.13-5.48; P = .023), readmission (OR, 1.617; 95% CI: 1.19-2.33; P = .003), myocardial infarction (OR, 0.50; 95% CI: 0.12-1.00; P = .048), and on a ventilator >48 hours (OR, 5.63; 95% CI: 1.40-22.62; P = .015). Conclusion NIDDM is an independent risk factor for sepsis, while IDDM is an independent risk factor for pneumonia, readmission, myocardial infarction, and remaining on a ventilator for greater than 48 hours following aRCR.

Source: JSES International

DOI: 10.1016/j.jseint.2023.06.024

Authors: Patricia E. Cerri-Droz, Kenny Ling, Samuel Aknoukh, David E. Komatsu, Edward D. Wang

Institution: Stony Brook University

Language: English

Topic: Shoulder Injury and Treatment

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,250