Anesthesia Preoperative Clinic Referral for Elevated Hba1c Reduces Complication Rate in Diabetic Patients Undergoing Total Joint Arthroplasty
| Author | Peter J. Kallio | en |
| Author | Jenea Nolan | en |
| Author | Amy C. Olsen | en |
| Author | Susan Breakwell | en |
| Author | Richard Topp | en |
| Author | Paul S. Pagel | en |
| Issued Date | 2015-06-01 | en |
| Abstract | Background: Diabetes mellitus (DM) is risk factor for complications after orthopedic surgery. Objectives: We tested the hypothesis that anesthesia preoperative clinic (APC) referral for elevated glycosylated hemoglobin (HbA1c) reduces complication rate after total joint arthroplasty (TJA). Patients and Methods: Patients (n = 203) with and without DM were chosen from 1,237 patients undergoing TJA during 2006 - 12. Patients evaluated in the APC had surgery in 2006 - 8 regardless of HbA1c (uncontrolled). Those evaluated between in subsequent two-year intervals were referred to primary care for HbA1c ≥ 10% and ≥ 8%, respectively, to improve DM control before surgery. Complications and mortality were quantified postoperatively and at three, six, and twelve months. Length of stay (LOS) and patients requiring a prolonged LOS (> 5 days) were recorded. Results: Patients (197 men, 6 women) underwent 71, 131, and 1 total hip, knee, and shoulder replacements, respectively. Patients undergoing TJA with uncontrolled HbA1c and those with HbA1c < 10%, but not those with HbA1c < 8%, had a higher incidence of coronary disease and hypercholesterolemia than patients without DM. An increase in complication rate was observed in DM patients with uncontrolled HbA1c versus patients without DM (P < 0.001); the complication rate progressively decreased with tighter HbA1c control. More DM patients with preoperative HbA1c that was uncontrolled or ≥ 10% required prolonged LOS versus those without DM (P < 0.001 and P = 0.0404, respectively). Conclusions: APC referral for elevated HbA1c reduces complication rate and the incidence of prolonged hospitalization during the first year after surgery in diabetics undergoing TJA. | en |
| DOI | https://doi.org/10.5812/aapm.5(3)2015.24376 | en |
| URI | https://brieflands.com/journals/aapm/articles/17469 | en |
| Keyword | Diabetes Mellitus | en |
| Keyword | Glycosylated Hemoglobin | en |
| Keyword | Orthopedic Surgery | en |
| Keyword | Arthroplasty | en |
| Publisher | Brieflands | en |
| Title | Anesthesia Preoperative Clinic Referral for Elevated Hba1c Reduces Complication Rate in Diabetic Patients Undergoing Total Joint Arthroplasty | en |
| Type | Research Article | en |
Files
Original bundle
1 - 1 of 1
Loading...
- Name:
- 17469-pdf.pdf
- Size:
- 124.6 KB
- Format:
- Adobe Portable Document Format
- Description:
- Article/s PDF