Postoperative hyperglycaemia control reduces postoperative complications in patients subject to total knee arthroplasty

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• 作者：Diego Reá ; tegui^a ; ^{diego_reategui@hotmail.com} ; Eduard Tornero^a ; Dragos Popescu^b ; Sergi Sastre^b ; Miquel Camafort^c ; Gracia Gines^d ; André ; s Combalí ; a^a ; Luis Lozano^b
• 关键词：Diabetes ; Hyperglycaemia ; Total knee arthroplasty ; Glycated haemoglobin ; Complications ; Primary care physician
• 刊名：The Knee
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：24
• 期：1
• 页码：128-136
• 全文大小：383 K
• 卷排序：24

文摘

The aim of our study was the early detection and treatment of patients with unknown alterations of the hydrocarbon metabolism subject to total knee arthroplasty in order to reduce the incidence of postoperative complications.MethodsPatients were classified as non-diabetic patients (group 1), diabetic patients (group 2) and patients with stress hyperglycaemia (group 3). The last two groups were recommended assessment by a primary care physician (PCP). After one year follow-up the groups were compared with respect to incidence of postoperative complications. The groups were also compared regarding the decrease or increase of HbA1c levels with the incidence of complications.ResultsOf the 228 patients, 116 (50%) were included in group 1, 40 (17.5%) in group 2 and 72 (31.6%) in group 3. Patients that consulted their PCP presented lower medical complication rates than those who did not (9.2% vs. 26.4%, P = 0.020). Not being attended by a PCP was an independent predictive factor of medical complication (odds ratio (OR): 21.3; 95% confidence interval (95% CI): 4.6–98.5), surgical site infection (OR: 4.1; 95% CI: 1.1–15.0) and mechanical complication (OR: 5.0; 95% CI: 1.3–18.8). A decrease of HbA1c value was related to less medical systemic complications (7.3% vs. 24.2%, P = 0.035).ConclusionsPatients with hyperglycaemia during the postoperative total knee arthroplasty period, who are controlled by the PCP present lower incidence of complications. Decrease of HbA1c value during postoperative total knee arthroplasty period leads to a lower rate of medical complications.