Infection risk increased with perioperative hemoglobin levels after shoulder arthroplasty in patients with diabetes
As perioperative hemoglobin A1c levels increased, risks for wound complications and deep infection increased in patients with diabetes who underwent shoulder arthroplasty, according to a recently published study in the Journal of the American Academy of Orthopaedic Surgeons.
“Patients with diabetes and [hemoglobin A1c] HbA1c levels of 8 and higher should be counseled that proceeding with surgery may place them at higher risk for wound complications and periprosthetic joint infection following shoulder arthroplasty,” Jourdan M. Cancienne, MD, told Healio.com/Orthopedics.
Cancienne and colleagues used a national database to identify 2,537 patients with diabetes who underwent primary shoulder arthroplasty and had HbA1c levels recorded within 3 months of the surgery date. Primary outcomes included a diagnosis of superficial would complication 6-months postoperatively and deep infection that needed surgical intervention 1-year postoperatively. Multivariable binomial logistic regression analysis that controlled for confounding variables was used to compare overall rates of wound complications and deep postoperative infection after shoulder arthroplasty in patients with diabetes vs. without diabetes.
Results showed patients with diabetes had significantly greater wound complication rates and deep infection. Investigators noted as the HbA1c levels increased, wound complication rates and deep postoperative infection rates increased. According to results from the receiver operating characteristics analysis, there was an inflection point at an HbA1c level of 8 mg/dL. – by Monica Jaramillo and Casey Tingle
Disclosures: The authors report no relevant financial disclosures.