دورية أكاديمية
أعرض في EDS

Dexamethasone, Glycemic Control, and Outcomes in Patients With Type 2 Diabetes Mellitus Undergoing Elective, Primary Total Joint Arthroplasty.

التفاصيل البيبلوغرافية
العنوان: Dexamethasone, Glycemic Control, and Outcomes in Patients With Type 2 Diabetes Mellitus Undergoing Elective, Primary Total Joint Arthroplasty.
المؤلفون: Porter SB; Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL, USA., Wilson JR; Division of Endocrinology, Diabetes, and Metabolism, Department of Internal Medicine, Mayo Clinic, Jacksonville, FL, USA., Sherman CE; Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL, USA., White LJ; Division of Health Care Delivery Research, Mayo Clinic, Jacksonville, FL, USA., Borkar SR; Division of Health Care Delivery Research, Mayo Clinic, Jacksonville, FL, USA., Spaulding AC; Division of Health Care Delivery Research, Mayo Clinic, Jacksonville, FL, USA.
المصدر: Arthroplasty today [Arthroplast Today] 2024 May 15; Vol. 27, pp. 101391. Date of Electronic Publication: 2024 May 15 (Print Publication: 2024).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 101681808 Publication Model: eCollection Cited Medium: Print ISSN: 2352-3441 (Print) Linking ISSN: 23523441 NLM ISO Abbreviation: Arthroplast Today Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [Maryland Heights, MO] : Elsevier, [2015]-
مستخلص: Background: Dexamethasone (DEX) has been shown to reduce pain and postoperative nausea and vomiting for patients undergoing elective total joint arthroplasty (TJA). We investigated the impact of DEX on glycemic control and outcomes in patients with type 2 diabetes mellitus undergoing elective primary TJA.
Methods: All patients with type 2 diabetes mellitus undergoing primary elective TJA between January 2016 and December 2021 at 4 sites within 1 hospital system were identified. Propensity scores were calculated to match patients receiving or not receiving DEX. Primary outcomes were perioperative blood glucose levels and the incidence of hyperglycemia. Secondary outcomes were the amount of insulin administered, the occurrence of 30-day postoperative surgical site infections, hospital readmission, and mortality.
Results: After matching, we identified 1372 patients. DEX administration was associated with a significant increase in mean blood glucose levels in mg/dL on postoperative days (PODs) 0 to 2: POD 0 (28.4, 95% confidence interval [CI]: 24.6-32.1), POD 1 (14.4, 95% CI: 10.1-18.8), POD 2 (12.4, 95% CI: 7.5-17.2) when comparing patients who did or did not receive DEX. Additionally, patients receiving DEX, compared to patients who did not receive DEX, had increased odds of experiencing hyperglycemia on POD 0 (odds ratio: 4.0, 95% CI: 3.1-5.2). DEX was not associated with a significant difference in insulin administration, surgical site infections, hospital readmission, or mortality.
Conclusions: In our review of 1372 patients with propensity-matched type 2 diabetes mellitus undergoing elective, primary TJA, we found that DEX administration was associated with an increased risk of elevated mean glucose on POD 0-2, hyperglycemia on POD 0, but was not associated with an increase in total insulin dose administered nor occurrence of surgical site infections, hospital readmission, or mortality within 30 days of surgery in patients who received DEX compared to patients who did not receive DEX.
Level of Evidence: IV.
(© 2024 The Authors.)
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فهرسة مساهمة: Keywords: Complications; Dexamethasone; Glycemic control; Total joint arthroplasty; Type 2 diabetes mellitus
تواريخ الأحداث: Date Created: 20240527 Latest Revision: 20240528
رمز التحديث: 20240528
مُعرف محوري في PubMed: PMC11126535
DOI: 10.1016/j.artd.2024.101391
PMID: 38800512
قاعدة البيانات: MEDLINE
الوصف
تدمد:2352-3441
DOI:10.1016/j.artd.2024.101391