Relations between long-term glycemic control and postoperative wound and infectious complications after total knee arthroplasty in type 2 diabetics

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Abstract

Background: The authors examined whether poor preoperative glucose control, as indicated by the hemoglobin A1c (HbA1c) level of more than 8%, is associated with postoperative wound and infectious complications in diabetic patients that have undergone total knee arthroplasty (TKA). Methods: One hundred and sixty-seven TKAs performed in 115 patients with type 2 diabetes mellitus, from January 2001 through March 2007, were retrospectively reviewed. Logistic regression was used to identify the variables that had a significant effect on the risk of wound complications or early deep infection. The variables considered were age, gender, body mass index, comorbidities, operation time, antibiotic-impregnated cement use, amount of blood transfusion, close suction drain use, duration of diabetes, method of diabetes treatment, diabetes complications, and preoperative HbA1c level. Results: The overall incidence of wound complications was 6.6% (n = 11) and there were seven cases (4.2%) of early postop- erative deep infection. Logistic regression revealed that the independent risk factors of wound complications were preoperative HbA1C ≥ 8% (odds ratio [OR], 6.07; 95% confidence interval [CI], 1.12 to 33.0) and operation time (OR, 1.01; 95% CI, 1.00 to 1.03). No variable examined was found to be significantly associated with the risk of early postoperative deep infection. Conclusions: Poorly controlled hyperglycemia before surgery may increase the incidence of wound complications among diabetic patients after TKA.

Original languageEnglish
Pages (from-to)118-123
Number of pages6
JournalClinics in Orthopedic Surgery
Volume5
Issue number2
DOIs
StatePublished - 1 Jun 2013

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Knee Replacement Arthroplasties
Diabetes Complications
Wounds and Injuries
Hemoglobins
Infection
Logistic Models
Odds Ratio
Confidence Intervals
Incidence
Suction
Blood Transfusion
Hyperglycemia
Type 2 Diabetes Mellitus
Comorbidity
Body Mass Index
Anti-Bacterial Agents
Glucose

Keywords

  • Early deep infection
  • Total knee replacements
  • Type 2 diabetes mellitus
  • Wound complication

Cite this

@article{ff76ae01f8264d578e698e4a21b4dd10,
title = "Relations between long-term glycemic control and postoperative wound and infectious complications after total knee arthroplasty in type 2 diabetics",
abstract = "Background: The authors examined whether poor preoperative glucose control, as indicated by the hemoglobin A1c (HbA1c) level of more than 8{\%}, is associated with postoperative wound and infectious complications in diabetic patients that have undergone total knee arthroplasty (TKA). Methods: One hundred and sixty-seven TKAs performed in 115 patients with type 2 diabetes mellitus, from January 2001 through March 2007, were retrospectively reviewed. Logistic regression was used to identify the variables that had a significant effect on the risk of wound complications or early deep infection. The variables considered were age, gender, body mass index, comorbidities, operation time, antibiotic-impregnated cement use, amount of blood transfusion, close suction drain use, duration of diabetes, method of diabetes treatment, diabetes complications, and preoperative HbA1c level. Results: The overall incidence of wound complications was 6.6{\%} (n = 11) and there were seven cases (4.2{\%}) of early postop- erative deep infection. Logistic regression revealed that the independent risk factors of wound complications were preoperative HbA1C ≥ 8{\%} (odds ratio [OR], 6.07; 95{\%} confidence interval [CI], 1.12 to 33.0) and operation time (OR, 1.01; 95{\%} CI, 1.00 to 1.03). No variable examined was found to be significantly associated with the risk of early postoperative deep infection. Conclusions: Poorly controlled hyperglycemia before surgery may increase the incidence of wound complications among diabetic patients after TKA.",
keywords = "Early deep infection, Total knee replacements, Type 2 diabetes mellitus, Wound complication",
author = "Han, {Hyuk Soo} and Kang, {Seung Baik}",
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T1 - Relations between long-term glycemic control and postoperative wound and infectious complications after total knee arthroplasty in type 2 diabetics

AU - Han, Hyuk Soo

AU - Kang, Seung Baik

PY - 2013/6/1

Y1 - 2013/6/1

N2 - Background: The authors examined whether poor preoperative glucose control, as indicated by the hemoglobin A1c (HbA1c) level of more than 8%, is associated with postoperative wound and infectious complications in diabetic patients that have undergone total knee arthroplasty (TKA). Methods: One hundred and sixty-seven TKAs performed in 115 patients with type 2 diabetes mellitus, from January 2001 through March 2007, were retrospectively reviewed. Logistic regression was used to identify the variables that had a significant effect on the risk of wound complications or early deep infection. The variables considered were age, gender, body mass index, comorbidities, operation time, antibiotic-impregnated cement use, amount of blood transfusion, close suction drain use, duration of diabetes, method of diabetes treatment, diabetes complications, and preoperative HbA1c level. Results: The overall incidence of wound complications was 6.6% (n = 11) and there were seven cases (4.2%) of early postop- erative deep infection. Logistic regression revealed that the independent risk factors of wound complications were preoperative HbA1C ≥ 8% (odds ratio [OR], 6.07; 95% confidence interval [CI], 1.12 to 33.0) and operation time (OR, 1.01; 95% CI, 1.00 to 1.03). No variable examined was found to be significantly associated with the risk of early postoperative deep infection. Conclusions: Poorly controlled hyperglycemia before surgery may increase the incidence of wound complications among diabetic patients after TKA.

AB - Background: The authors examined whether poor preoperative glucose control, as indicated by the hemoglobin A1c (HbA1c) level of more than 8%, is associated with postoperative wound and infectious complications in diabetic patients that have undergone total knee arthroplasty (TKA). Methods: One hundred and sixty-seven TKAs performed in 115 patients with type 2 diabetes mellitus, from January 2001 through March 2007, were retrospectively reviewed. Logistic regression was used to identify the variables that had a significant effect on the risk of wound complications or early deep infection. The variables considered were age, gender, body mass index, comorbidities, operation time, antibiotic-impregnated cement use, amount of blood transfusion, close suction drain use, duration of diabetes, method of diabetes treatment, diabetes complications, and preoperative HbA1c level. Results: The overall incidence of wound complications was 6.6% (n = 11) and there were seven cases (4.2%) of early postop- erative deep infection. Logistic regression revealed that the independent risk factors of wound complications were preoperative HbA1C ≥ 8% (odds ratio [OR], 6.07; 95% confidence interval [CI], 1.12 to 33.0) and operation time (OR, 1.01; 95% CI, 1.00 to 1.03). No variable examined was found to be significantly associated with the risk of early postoperative deep infection. Conclusions: Poorly controlled hyperglycemia before surgery may increase the incidence of wound complications among diabetic patients after TKA.

KW - Early deep infection

KW - Total knee replacements

KW - Type 2 diabetes mellitus

KW - Wound complication

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