Metabolic syndrome and shoulder arthroplasty: epidemiology and peri-operative outcomes
Murphy, A.B., Menendez, M.E., Watson, S.L. et al.Shoulder
Purpose
Little is known about metabolic syndrome in the peri-operative shoulder surgery setting. We sought to determine the prevalence of metabolic syndrome in patients undergoing shoulder arthroplasty, and to characterize its relationship with in-hospital adverse events, prolonged length of stay, and non-routine disposition.
Methods
Using discharge records from the 2002–2011 Nationwide Inpatient Sample, temporal trends were assessed and multivariable logistic regression modeling was used to measure the association of metabolic syndrome with peri-operative outcomes.
Results
The prevalence of metabolic syndrome increased by 257 % from 2002 to 2011 (4.2 to 15.0 %). Metabolic syndrome was associated with increased aggregate morbidity (OR 1.34, 95 % CI 1.30–1.38), including acute renal failure (OR 1.51, 95 % CI 1.41–1.63), surgical site infection (OR 1.41, 95 % CI 1.16–1.71), myocardial infarction (OR 1.32, 95 % CI 1.12–1.55), acute posthemorrhagic anemia (OR 1.30, 95 % CI 1.26–1.34), and pulmonary embolism (OR 1.27, 95 % CI 1.06–1.52). It was also associated with prolonged hospital stay (OR 1.13, 95 % CI 1.10–1.16), non-homebound discharge (OR 1.29, 95 % CI 1.26–1.32), and increased blood transfusion use (OR 1.09, 95 % CI 1.06–1.13).
Conclusions
Metabolic syndrome is increasing rapidly among shoulder arthroplasty patients and is associated with considerable peri-operative morbidity and resource utilization. Greater awareness of metabolic syndrome and its health consequences may contribute to improvements in the peri-operative management of shoulder arthroplasty patients.
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