The Particulars: Prior research indicates that, in general, patients with diabetes who undergo surgery are at higher risk for comorbidities and perioperative complications. Little is known, however, about the impact of diabetes on perioperative complications among total shoulder arthroplasty (TSA) patients.

Data Breakdown: Using national data, study investigators analyzed comorbidities, perioperative complications, and hospitalization data among patients who underwent primary TSA from 2005 to 2010. Patients were divided into those without diabetes, those with controlled diabetes, and those with uncontrolled diabetes. Overall, perioperative complication rates were:

  • 5.9% for patients without diabetes.
  • 7.1% for those with controlled diabetes.
  • 10.1% for those with uncontrolled diabetes.

Controlled diabetes correlated with high rates of DVT, increased need for blood transfusions, more frequent non-routine discharges, and longer lengths of stay (LOS). Uncontrolled diabetes was an even stronger predictor than controlled diabetes for increased hospital charges, longer LOS, and non-routine discharge.

Take Home Pearl: Patients with uncontrolled diabetes appear to be at greater risk for perioperative complications, higher costs, and longer hospitalizations following TSA when compared with people who do not have diabetes or those with controlled diabetes.