Impact of Diabetes Mellitus on Outcomes of Patients With Knee Osteoarthritis Who Underwent Knee Arthroplasty: An Analysis of the Nationwide Inpatient Sample.

Pius E Ojemolon,Omokunmi P Adekola,Jeremiah Bello,Ehizogie Edigin,Clark Azubuike,Hafeez Shaka,Trisha Marie A Gomez,Precious Eseaton

doi:10.7759/cureus.8902

Abstract

BackgroundKnee arthroplasty is one of the most common reasons for hospitalizations in the United States. Diabetes mellitus is thought to be associated with adverse perioperative outcomes. We sought to demonstrate the effect of comorbid diabetes on hospitalizations involving patients with knee osteoarthritis who had knee arthroplasty.Materials and methodsData was obtained from the Nationwide Inpatient Sample (NIS) for 2016 and 2017. ICD-10 codes were used to obtain a cohort of patient who were principally admitted for knee osteoarthritis who underwent knee arthroplasty. The patients were further divided according to diabetic status. The primary outcome compared inpatient mortality. Secondary outcomes included mean length of hospital stay, total hospital charges, presence of secondary diagnoses on discharge of acute kidney injury, surgical site infection, sepsis, thromboembolic events, non-ST segment elevation myocardial infarction (NSTEMI).ResultsPatients with diabetes mellitus had a lower adjusted odds ratio for mortality (aOR: 0.45 95% CI: 0.221 - 0.920, p = 0.029), with no significant difference in total hospital charges and length of hospital stay. Interestingly, patients with diabetes had lower odds of NSTEMI; 0.53 (95% CI: 0.369 - 0.750, p < 0.001) sepsis; 0.64 (95% CI: 0.449 - 0.924, p = 0.017) and DVT; 0.67 (95% CI: 0.546 - 0.822, p < 0.001).ConclusionUncomplicated diabetes mellitus is not associated with adverse outcomes in patients hospitalized with knee osteoarthritis who had knee arthroplasty.

Highlights

Osteoarthritis (OA) is a chronic, degenerative disease of the joints that primarily affects the cartilage [1]
ICD-10 codes were used to obtain a cohort of patient who were principally admitted for knee osteoarthritis who underwent knee arthroplasty
Patients with diabetes mellitus had a lower adjusted odds ratio for mortality, with no significant difference in total hospital charges and length of hospital stay

Summary

Introduction

Osteoarthritis (OA) is a chronic, degenerative disease of the joints that primarily affects the cartilage [1]. OA is the most common degenerative joint disease globally and represents a substantial health burden with notable implications for the individuals and healthcare systems affected. The knee joint is most commonly affected by OA, and individuals suffering from knee OA commonly experience pain, stiffness and associated loss of function in the affected knees [2, 3]. Knee OA is the most common reason for total knee arthroplasty (KA) in the United States [4]. Knee arthroplasty is one of the most common reasons for hospitalizations in the United States. We sought to demonstrate the effect of comorbid diabetes on hospitalizations involving patients with knee osteoarthritis who had knee arthroplasty

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