Components of metabolic syndrome as significant risk factors for postoperative complications following total shoulder arthroplasty: hypertension, diabetes, and obesity

Fassler, Richelle; Ling, Kenny; Burgan, Jane; Komatsu, David E.; Wang, Edward D.

doi:10.1016/j.jseint.2023.08.019

Cited by 2 publications

(3 citation statements)

References 28 publications

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“…Our findings are consistent with the current literature on the subject. The greater risk of complications in patients with MetS is well documented in both orthopaedic surgery 35,[37][38][39][40][41] and other surgical fields. 32,[42][43][44][45] Cichos et al, 46 in a similar study assessing perioperative outcomes in hip fracture, found MetS increased complications, but reduced mortality.…”

Section: Discussionmentioning

confidence: 99%

“…This modified MetS has been widely used in related literature, both in orthopaedics and otherwise. 32–37…”

Section: Methodsmentioning

confidence: 99%

“…This modified MetS has been widely used in related literature, both in orthopaedics and otherwise. [32][33][34][35][36][37] To assess each component of MetS individually, patients with a single component (eg, obesity) were compared with a metabolically healthy cohort without the characteristic of interest (eg, nonobese patients, who, by definition, do not have MetS). For patients with MetS, the comparison group consisted of patients without MetS or obesity.…”

Section: Statistical Analysis Of Metsmentioning

confidence: 99%

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A component-based analysis of metabolic syndrome's impact on 30-day outcomes after hip fracture: reduced mortality in obese patients

Singh,

Kotzur,

Vivancos-Koopman

et al. 2024

OTA International

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Introduction: Hip fractures are a common injury associated with significant morbidity and mortality. In the United States, there has been a rapid increase in the prevalence of metabolic syndrome (MetS), a condition comprised several common comorbidities, including obesity, diabetes mellitus, and hypertension, that may worsen perioperative outcomes. This article assesses the impact of MetS and its components on outcomes after hip fracture surgery. Methods: Patients who underwent nonelective operative treatment for traumatic hip fractures were identified in the 2015–2020 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Baseline characteristics between groups were compared, and significant differences were included as covariates. Multivariate regression was performed to assess the impact of characteristics of interest on postoperative outcomes. Patients with MetS, or a single one of its constitutive components—hypertension, diabetes, and obesity—were compared with metabolically healthy cohorts. Results: In total 95,338 patients were included. Patients with MetS had increased complications (OR 1.509; P < 0.001), but reduced mortality (OR 0.71; P < 0.001). Obesity alone was also associated with increased complications (OR 1.14; P < 0.001) and reduced mortality (OR 0.736; P < 0.001). Both hypertension and diabetes alone increased complications (P < 0.001) but had no impact on mortality. Patients with MetS did, however, have greater odds of adverse discharge (OR 1.516; P < 0.001), extended hospital stays (OR 1.18; P < 0.001), and reoperation (OR 1.297; P = 0.003), but no significant difference in readmission rate. Conclusion: Patients with MetS had increased complications but decreased mortality. Our component-based analysis showed had obesity had a similar effect: increased complications but lower mortality. These results may help surgeons preoperatively counsel patients with hip fracture about their postoperative risks.

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Section: Discussionmentioning

confidence: 99%

“…This modified MetS has been widely used in related literature, both in orthopaedics and otherwise. 32–37…”

Section: Methodsmentioning

confidence: 99%

Section: Statistical Analysis Of Metsmentioning

confidence: 99%

See 1 more Smart Citation

A component-based analysis of metabolic syndrome's impact on 30-day outcomes after hip fracture: reduced mortality in obese patients

Singh,

Kotzur,

Vivancos-Koopman

et al. 2024

OTA International

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Effect of Insulin Dependence on Perioperative Risk in Patients With Diabetes Undergoing Total Shoulder Arthroplasty

Razaeian,

Zhang

2024

Orthopedics

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Background: Approximately 15% of patients who undergo total shoulder arthroplasty (TSA) have diabetes mellitus, and this group is particularly at risk for perioperative complications. The objective of this study was to quantify the effects of insulin dependence on the risk of 30-day perioperative adverse events after TSA in patients with diabetes mellitus using a large national database. Materials and Methods: We retrospectively identified patients with diabetes mellitus who underwent TSA in the National Surgical Quality Improvement Program (NSQIP) database from 2011 to 2020. Patients were grouped as having insulin-dependent or non–insulin-dependent diabetes mellitus. The primary outcome was 30-day complication, and secondary outcome variables included 30-day readmission, reoperation, and death. Multivariable logistic regression analyses adjusted for baseline differences were performed. The cohort included 5888 patients with diabetes mellitus who underwent TSA, with 1705 patients in the insulin-dependent group and 4183 patients in the non–insulin-dependent group. Results: The 30-day postoperative complication rate was higher in patients with insulin-dependent diabetes mellitus (8.7%) than in patients with non–insulin-dependent diabetes mellitus (5.6%). The 30-day hospital readmission rate was higher in patients with insulin-dependent diabetes mellitus (4.8%) than in patients with non–insulin-dependent diabetes mellitus (3.3%). These significant differences in complication and readmission rates persisted in the multivariable logistic regression analyses after adjusting for baseline differences between the two groups. Reoperation and death were not associated with insulin dependence. Conclusion: Patients with insulin-dependent diabetes mellitus have higher odds of episode-of-care complication and readmission compared with patients with non–insulin-dependent diabetes mellitus, even after adjusting for between-group baseline differences. [ Orthopedics . 20XX;4X(X):XXX–XXX.]

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Components of metabolic syndrome as significant risk factors for postoperative complications following total shoulder arthroplasty: hypertension, diabetes, and obesity

Cited by 2 publications

References 28 publications

A component-based analysis of metabolic syndrome's impact on 30-day outcomes after hip fracture: reduced mortality in obese patients

A component-based analysis of metabolic syndrome's impact on 30-day outcomes after hip fracture: reduced mortality in obese patients

Effect of Insulin Dependence on Perioperative Risk in Patients With Diabetes Undergoing Total Shoulder Arthroplasty

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