Trends 2001 to 2008 in incidence and immediate postoperative outcomes for major joint replacement among Spanish adults suffering diabetes

• Published in: European journal of orthopaedic surgery & traumatology 2013, Vol.23 (1), p.53-59
• Main Authors: Martinez-Huedo, Maria A., Villanueva, Manuel, de Andres, Ana Lopez, Hernandez-Barrera, Valentin, Carrasco-Garrido, Pilar, Gil, Angel, Martinez, David, Jiménez-Garcia, Rodrigo
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Arthroplasty, Replacement, Hip - mortality; Arthroplasty, Replacement, Hip - statistics & numerical data; Arthroplasty, Replacement, Hip - trends; Arthroplasty, Replacement, Knee - mortality; Arthroplasty, Replacement, Knee - statistics & numerical data; Arthroplasty, Replacement, Knee - trends; Diabetes; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 2 - complications; Female; Hospital Charges - statistics & numerical data; Hospital Mortality; Humans; Length of Stay - statistics & numerical data; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Osteoarthritis, Hip - surgery; Osteoarthritis, Knee - surgery; Postoperative period; Spain; Surgical Orthopedics; Traumatic Surgery; Treatment Outcome; Trends
• ISSN: 1633-8065; 1432-1068
• DOI: 10.1007/s00590-011-0915-6

Objectives To analyze the trend of incidence rates of primary total knee (TKA) and primary total hip arthroplasty (THA) due to osteoarthritis among Spanish adults suffering diabetes (type-1 and 2) from 2001 to 2008 and analyze in-hospital mortality (IHM), length of stay (LOS) and hospital charges compared with non-diabetic patients. Methods From the Spanish National Hospital Database, we selected 250,205 patients with TKA and 122,926 patients with THA; 12 and 9% of patients undergoing TKA and THA, respectively, were diabetes sufferers, of them, 1.6% was classified as type 1 in each procedure. Results Incidence of both procedures increased over the period, but diabetic patients had a larger increment compared with non-diabetic patients. The ratio of diabetes versus non-diabetes sufferers undergoing TKA increased from 0.10 in 2001 to 0.16 in 2008 and from 0.08 to 0.11 for THA. Unadjusted IHM was higher among type-2 diabetic adults in both procedures. IHM rate did not show a secular time trend among diabetic patients. LOS was significantly longer among patients with diabetes type-1 and 2 undergoing THP when compared with non-diabetic patients. Hospital charges were higher among diabetic versus non-diabetic patients for both procedures showing a significant increase over the period. Conclusions Immediate postoperative outcomes for major joint replacement are worse among persons with than without diabetes, and prevalence of diabetes is increasing in patients undergoing these surgeries.