These authors investigated the association between postoperative glycemic variability and short-term complications for 1074 patients having total shoulder arthroplasty (TSA) and reverse total shoulder arthroplasty (RTSA).
The mean patient age was 70 years, and 40% (!) of patients had a preoperative diagnosis of diabetes mellitus.
A postoperative infection developed in 3 of 636 (0.5%) patients without diabetes compared with 9 of 424 (2.1%) patients with diabetes. Younger patient age and a preoperative diagnosis of diabetes mellitus showed statistically significant associations with postoperative infection.
The first in-hospital glucose measurement beyond the reference tertile of 70-140 mg/dL showed a statistically significant association with postoperative infection, whereas the second and third glucose measurements showed no association with postoperative infection.
The authors suggest that in-hospital glycemic control, as well as preoperative glycemic control and optimization, may be beneficial for reducing postoperative infections following shoulder arthroplasty.
Comment: Glycemic control before and immediately after shoulder arthroplasty may hold promise as modifiable risk factors for infection.
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