Viens Nicholas A, Hug Kevin T, Marchant Milford H, Cook Chad, Vail Thomas Parker, Bolognesi Michael P
Division of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 27710, USA.
J Surg Orthop Adv. 2012 Winter;21(4):253-60. doi: 10.3113/jsoa.2012.0253.
The objective of this study was to determine whether the type of diabetes mellitus (DM) affected the incidence of immediate perioperative complications following joint replacement. From 1988 to 2003, the Nationwide Inpatient Sample recognized 65,769 patients with DM who underwent total hip and knee arthroplasty in the United States. Bivariate and multivariate analyses compared patients with type 1 (n = 8728) and type 2 (n = 57,041) DM regarding common perioperative complications, mortality, and hospital course alterations. Type 1 DM patients had increased length of stays and inflation-adjusted costs after surgery (p < .001). Type 1 patients also had significant increases in the incidence of myocardial infarction, pneumonia, urinary tract infection, postoperative hemorrhage, wound infection, and death (p < .02). Perhaps because of the differences in the duration of disease and their underlying pathologies, patients with type 1 diabetes carry more significant overall perioperative risks and require more health care resources compared with patients with type 2 diabetes following hip and knee arthroplasty.
本研究的目的是确定糖尿病（DM）类型是否会影响关节置换术后围手术期即刻并发症的发生率。1988年至2003年期间，美国全国住院患者样本数据库识别出65769例接受全髋关节和膝关节置换术的糖尿病患者。双变量和多变量分析比较了1型糖尿病患者（n = 8728）和2型糖尿病患者（n = 57041）在常见围手术期并发症、死亡率及住院病程变化方面的情况。1型糖尿病患者术后住院时间延长，经通胀调整后的费用增加（p < 0.001）。1型糖尿病患者心肌梗死、肺炎、尿路感染、术后出血、伤口感染及死亡的发生率也显著增加（p < 0.02）。或许由于疾病病程及潜在病理状况的差异，与2型糖尿病患者相比，1型糖尿病患者在髋关节和膝关节置换术后总体围手术期风险更高，需要更多的医疗资源。
