Diabetes Mellitus, Hyperglycemia, Hemoglobin A1C and the Risk of Prosthetic Joint Infections in Total Hip and Knee Arthroplasty

Hilal Maradit Kremers; Laura W. Lewallen; Tad M. Mabry; Daniel J. Berry; Elie F. Berbari; Douglas R. Osmon

doi:10.1016/j.arth.2014.10.009

Diabetes Mellitus, Hyperglycemia, Hemoglobin A1C and the Risk of Prosthetic Joint Infections in Total Hip and Knee Arthroplasty

Hilal Maradit Kremers, Laura W. Lewallen, Tad M. Mabry, Daniel J. Berry, Elie F. Berbari, Douglas R. Osmon

Research output: Contribution to journal › Article › peer-review

96 Scopus citations

Abstract

Diabetes mellitus is an established risk factor for infections but evidence is conflicting to what extent perioperative hyperglycemia, glycemic control and treatment around the time of surgery modify the risk of prosthetic joint infections (PJIs). In a cohort of 20,171 total hip and knee arthroplasty procedures, we observed a significantly higher risk of PJIs among patients with a diagnosis of diabetes mellitus (hazard ratio [HR] 1.55, 95% CI 1.11, 2.16), patients using diabetes medications (HR 1.56, 95% CI 1.08, 2.25) and patients with perioperative hyperglycemia (HR 1.59, 95% CI 1.07, 2.35), but the effects were attenuated after adjusting for body mass index, type of surgery, ASA score and operative time. Although data were limited, there was no association between hemoglobin A1c values and PJIs.

Original language	English (US)
Pages (from-to)	439-443
Number of pages	5
Journal	Journal of Arthroplasty
Volume	30
Issue number	3
DOIs	https://doi.org/10.1016/j.arth.2014.10.009
State	Published - Mar 1 2015
Externally published	Yes

Keywords

Diabetes mellitus
Hemoglobin A1c
Hyperglycemia
Infection
Total joint arthroplasty

ASJC Scopus subject areas

Orthopedics and Sports Medicine

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10.1016/j.arth.2014.10.009

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title = "Diabetes Mellitus, Hyperglycemia, Hemoglobin A1C and the Risk of Prosthetic Joint Infections in Total Hip and Knee Arthroplasty",

abstract = "Diabetes mellitus is an established risk factor for infections but evidence is conflicting to what extent perioperative hyperglycemia, glycemic control and treatment around the time of surgery modify the risk of prosthetic joint infections (PJIs). In a cohort of 20,171 total hip and knee arthroplasty procedures, we observed a significantly higher risk of PJIs among patients with a diagnosis of diabetes mellitus (hazard ratio [HR] 1.55, 95% CI 1.11, 2.16), patients using diabetes medications (HR 1.56, 95% CI 1.08, 2.25) and patients with perioperative hyperglycemia (HR 1.59, 95% CI 1.07, 2.35), but the effects were attenuated after adjusting for body mass index, type of surgery, ASA score and operative time. Although data were limited, there was no association between hemoglobin A1c values and PJIs.",

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AU - Mabry, Tad M.

AU - Berry, Daniel J.

AU - Berbari, Elie F.

AU - Osmon, Douglas R.

PY - 2015/3/1

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N2 - Diabetes mellitus is an established risk factor for infections but evidence is conflicting to what extent perioperative hyperglycemia, glycemic control and treatment around the time of surgery modify the risk of prosthetic joint infections (PJIs). In a cohort of 20,171 total hip and knee arthroplasty procedures, we observed a significantly higher risk of PJIs among patients with a diagnosis of diabetes mellitus (hazard ratio [HR] 1.55, 95% CI 1.11, 2.16), patients using diabetes medications (HR 1.56, 95% CI 1.08, 2.25) and patients with perioperative hyperglycemia (HR 1.59, 95% CI 1.07, 2.35), but the effects were attenuated after adjusting for body mass index, type of surgery, ASA score and operative time. Although data were limited, there was no association between hemoglobin A1c values and PJIs.

AB - Diabetes mellitus is an established risk factor for infections but evidence is conflicting to what extent perioperative hyperglycemia, glycemic control and treatment around the time of surgery modify the risk of prosthetic joint infections (PJIs). In a cohort of 20,171 total hip and knee arthroplasty procedures, we observed a significantly higher risk of PJIs among patients with a diagnosis of diabetes mellitus (hazard ratio [HR] 1.55, 95% CI 1.11, 2.16), patients using diabetes medications (HR 1.56, 95% CI 1.08, 2.25) and patients with perioperative hyperglycemia (HR 1.59, 95% CI 1.07, 2.35), but the effects were attenuated after adjusting for body mass index, type of surgery, ASA score and operative time. Although data were limited, there was no association between hemoglobin A1c values and PJIs.

KW - Diabetes mellitus

KW - Hemoglobin A1c

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KW - Infection

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Diabetes Mellitus, Hyperglycemia, Hemoglobin A1C and the Risk of Prosthetic Joint Infections in Total Hip and Knee Arthroplasty

Abstract

Keywords

ASJC Scopus subject areas

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