Metabolic syndrome and shoulder arthroplasty: epidemiology and peri-operative outcomes

Purpose Little is known about metabolic syndrome in the peri-operative shoulder surgery setting. We sought to determine the prevalence of metabolic syndrome in patients undergoing shoulder arthroplasty, and to characterize its relationship with in-hospital adverse events, prolonged length of stay, a...

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Bibliographic Details
Published in:International orthopaedics 2016-09, Vol.40 (9), p.1927-1933
Main Authors: Murphy, Austin B., Menendez, Mariano E., Watson, Shawna L., Ponce, Brent A.
Format: Article
Language:English
Subjects:
Arthroplasty, Replacement
Humans
Length of Stay
Medicine
Medicine & Public Health
Metabolic Syndrome
Original Paper
Orthopedics
Postoperative Complications
Retrospective Studies
Risk Factors
Shoulder
Shoulder Joint
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Summary:Purpose Little is known about metabolic syndrome in the peri-operative shoulder surgery setting. We sought to determine the prevalence of metabolic syndrome in patients undergoing shoulder arthroplasty, and to characterize its relationship with in-hospital adverse events, prolonged length of stay, and non-routine disposition. Methods Using discharge records from the 2002–2011 Nationwide Inpatient Sample, temporal trends were assessed and multivariable logistic regression modeling was used to measure the association of metabolic syndrome with peri-operative outcomes. Results The prevalence of metabolic syndrome increased by 257 % from 2002 to 2011 (4.2 to 15.0 %). Metabolic syndrome was associated with increased aggregate morbidity (OR 1.34, 95 % CI 1.30–1.38), including acute renal failure (OR 1.51, 95 % CI 1.41–1.63), surgical site infection (OR 1.41, 95 % CI 1.16–1.71), myocardial infarction (OR 1.32, 95 % CI 1.12–1.55), acute posthemorrhagic anemia (OR 1.30, 95 % CI 1.26–1.34), and pulmonary embolism (OR 1.27, 95 % CI 1.06–1.52). It was also associated with prolonged hospital stay (OR 1.13, 95 % CI 1.10–1.16), non-homebound discharge (OR 1.29, 95 % CI 1.26–1.32), and increased blood transfusion use (OR 1.09, 95 % CI 1.06–1.13). Conclusions Metabolic syndrome is increasing rapidly among shoulder arthroplasty patients and is associated with considerable peri-operative morbidity and resource utilization. Greater awareness of metabolic syndrome and its health consequences may contribute to improvements in the peri-operative management of shoulder arthroplasty patients.
ISSN:0341-2695
1432-5195
DOI:10.1007/s00264-016-3214-3