Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, 2300 Eye St NW, Washington, DC, 20037, USA.
Weill Cornell Medical College, 1300 York Avenue, New York, NY, 10021, USA.
Eur J Orthop Surg Traumatol. 2023 May;33(4):1217-1222. doi: 10.1007/s00590-022-03277-0. Epub 2022 May 10.
Past research has shown diabetic patients, including those of geriatric age, to be at an increased risk of postoperative complications following various surgeries, including revision total hip arthroplasty (rTHA). However, whether these risks are disproportionately greater in octogenarian patients has not been well investigated. This study aimed to determine whether diabetic octogenarians are at an increased risk of postoperative complications following rTHA.
The national surgical quality improvement program database was used to identify all diabetic patients who underwent rTHA from 2007 to 2018. Patients were divided into two groups: an aged 65 to 79 cohort and an aged 80 to 89 cohort. Patient demographics, comorbidities, and postoperative complications were assessed and compared between the two aged cohorts, with the utilization of bivariate and multivariate analyses.
Of the 1184 diabetic patients who underwent rTHA, 906 (76.5%) patients were in the aged 65 to 79 cohort and 278 (23.5%) patients were in the aged 80 to 89 cohort. After adjusting for patient demographics and medical comorbidities, compared to patients in the aged 65 to 79 group, diabetic patients who were 80 to 89 years old were found to have an increased risk of extended length of hospital stay (OR 1.67; p = 0.017).
Diabetic octogenarian patients have an increased risk for a prolonged hospital stay following rTHA relative to their younger diabetic geriatric counterparts. Orthopedic surgeons should be aware of these increased risks to properly educate diabetic octogenarians and assist in surgical management decision making in these patients considering rTHA.
既往研究表明,包括老年患者在内的糖尿病患者在接受各种手术后(包括翻修全髋关节置换术[rTHA])发生术后并发症的风险增加。然而,80 岁以上患者的这些风险是否不成比例地更高尚未得到很好的研究。本研究旨在确定糖尿病 80 岁以上患者在接受 rTHA 后是否有更高的术后并发症风险。
使用国家手术质量改进计划数据库确定了 2007 年至 2018 年间接受 rTHA 的所有糖尿病患者。患者分为两个年龄组:65 至 79 岁组和 80 至 89 岁组。评估并比较了两组患者的人口统计学特征、合并症和术后并发症,并进行了双变量和多变量分析。
在 1184 例接受 rTHA 的糖尿病患者中,906 例(76.5%)患者年龄在 65 至 79 岁,278 例(23.5%)患者年龄在 80 至 89 岁。调整患者人口统计学特征和合并症后,与 65 至 79 岁年龄组的患者相比,80 至 89 岁的糖尿病患者住院时间延长的风险增加(OR 1.67;p=0.017)。
与年轻的糖尿病老年患者相比,80 岁以上的糖尿病 80 岁以上患者在接受 rTHA 后住院时间延长的风险增加。骨科医生应意识到这些增加的风险,以便为考虑接受 rTHA 的糖尿病 80 岁以上患者提供适当的教育,并协助手术管理决策。