Abstract：
OBJECTIVE: This study investigates the association between insulin-dependent and non-insulin-dependent diabetes and 30-day postoperative complications following aseptic revision total shoulder arthroplasty (TSA).
METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who underwent aseptic revision TSA from 2015 to 2021. The study population was divided into three groups based on diabetic status: nondiabetes, insulin-dependent diabetes, and non-insulin-dependent diabetes. Logistic regression analysis was conducted to investigate the relationship between diabetic status and postoperative complications.
RESULTS: Compared to nondiabetes, insulin-dependent diabetes was independently associated with a significantly greater likelihood of experiencing any complication (OR 1.59, 95% CI 1.08-2.35; P = 0.020) and LOS > 2 days (OR 1.73, 95% CI 1.13-2.65; P = 0.012). Compared to nondiabetes, non-insulin-dependent diabetes was not independently associated with a significantly greater likelihood of experiencing complications. Preoperative insulin-dependent diabetic status was significantly associated with a greater rate of early postoperative complications following aseptic revision TSA, while preoperative non-insulin-dependent diabetic status was not.
CONCLUSIONS: Preoperative insulin-dependent diabetic status was significantly associated with a greater rate of early postoperative complications following aseptic revision TSA. A better understanding of the role diabetes, both insulin-dependent and non-insulin-dependent, as a risk factor may help physicians better risk stratify and select surgical candidates for revision TSA.
METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried for all patients who underwent aseptic revision TSA from 2015 to 2021. The study population was divided into three groups based on diabetic status: nondiabetes, insulin-dependent diabetes, and non-insulin-dependent diabetes. Logistic regression analysis was conducted to investigate the relationship between diabetic status and postoperative complications.
RESULTS: Compared to nondiabetes, insulin-dependent diabetes was independently associated with a significantly greater likelihood of experiencing any complication (OR 1.59, 95% CI 1.08-2.35; P = 0.020) and LOS > 2 days (OR 1.73, 95% CI 1.13-2.65; P = 0.012). Compared to nondiabetes, non-insulin-dependent diabetes was not independently associated with a significantly greater likelihood of experiencing complications. Preoperative insulin-dependent diabetic status was significantly associated with a greater rate of early postoperative complications following aseptic revision TSA, while preoperative non-insulin-dependent diabetic status was not.
CONCLUSIONS: Preoperative insulin-dependent diabetic status was significantly associated with a greater rate of early postoperative complications following aseptic revision TSA. A better understanding of the role diabetes, both insulin-dependent and non-insulin-dependent, as a risk factor may help physicians better risk stratify and select surgical candidates for revision TSA.
摘要：
目的：本研究调查了胰岛素依赖型和非胰岛素依赖型糖尿病与无菌翻修全肩关节置换术（TSA）术后30天并发症之间的关系。
方法：美国外科医生学会国家外科质量改进计划数据库查询了2015年至2021年接受无菌翻修TSA的所有患者。研究人群根据糖尿病状态分为三组：非糖尿病，胰岛素依赖型糖尿病，和非胰岛素依赖型糖尿病。采用Logistic回归分析探讨糖尿病状态与术后并发症的关系。
结果：与非糖尿病相比，胰岛素依赖型糖尿病与发生任何并发症的可能性显著增加(OR1.59,95%CI1.08-2.35;P=0.020)和LOS>2天(OR1.73,95%CI1.13-2.65;P=0.012)独立相关.与非糖尿病相比，非胰岛素依赖型糖尿病与出现并发症的可能性显著增加无关.术前胰岛素依赖型糖尿病状态与无菌翻修TSA术后早期并发症的发生率显著相关，而术前非胰岛素依赖性糖尿病状态没有。
结论：术前胰岛素依赖型糖尿病状态与无菌翻修TSA术后早期并发症的发生率显著相关。更好地了解糖尿病的作用，胰岛素依赖性和非胰岛素依赖性，作为一个危险因素,可能有助于医师更好地进行风险分层,并为TSA翻修选择手术候选者.
方法：美国外科医生学会国家外科质量改进计划数据库查询了2015年至2021年接受无菌翻修TSA的所有患者。研究人群根据糖尿病状态分为三组：非糖尿病，胰岛素依赖型糖尿病，和非胰岛素依赖型糖尿病。采用Logistic回归分析探讨糖尿病状态与术后并发症的关系。
结果：与非糖尿病相比，胰岛素依赖型糖尿病与发生任何并发症的可能性显著增加(OR1.59,95%CI1.08-2.35;P=0.020)和LOS>2天(OR1.73,95%CI1.13-2.65;P=0.012)独立相关.与非糖尿病相比，非胰岛素依赖型糖尿病与出现并发症的可能性显著增加无关.术前胰岛素依赖型糖尿病状态与无菌翻修TSA术后早期并发症的发生率显著相关，而术前非胰岛素依赖性糖尿病状态没有。
结论：术前胰岛素依赖型糖尿病状态与无菌翻修TSA术后早期并发症的发生率显著相关。更好地了解糖尿病的作用，胰岛素依赖性和非胰岛素依赖性，作为一个危险因素,可能有助于医师更好地进行风险分层,并为TSA翻修选择手术候选者.
