Chronic Kidney Disease Is Associated with High Mortality Risk in Patients with Diabetes after Primary Shoulder Arthroplasty: A Nationwide Population-Based Cohort Study
The number of diabetic patients with chronic kidney disease (CKD) undergoing shoulder arthroplasty is growing. This study aims to compare perioperative outcomes of shoulder arthroplasty in diabetic patients at different renal function stages. Between 1998 and 2013, a total of 4443 diabetic patients...
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| Format: | Article |
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MDPI AG
2021-05-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/11/5/822 |
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| author | Meng-Hao Lin Su-Ju Lin Liang-Tseng Kuo Tien-Hsing Chen Chi-Lung Chen Pei-An Yu Yao-Hung Tsai Wei-Hsiu Hsu |
| author_facet | Meng-Hao Lin Su-Ju Lin Liang-Tseng Kuo Tien-Hsing Chen Chi-Lung Chen Pei-An Yu Yao-Hung Tsai Wei-Hsiu Hsu |
| author_sort | Meng-Hao Lin |
| collection | DOAJ |
| description | The number of diabetic patients with chronic kidney disease (CKD) undergoing shoulder arthroplasty is growing. This study aims to compare perioperative outcomes of shoulder arthroplasty in diabetic patients at different renal function stages. Between 1998 and 2013, a total of 4443 diabetic patients with shoulder arthroplasty were enrolled: 1174 (26%) had CKD without dialysis (CKD group), 427 (9%) underwent dialysis (dialysis group), and 3042 (68%) had no CKD (non-CKD group). Compared with the non-CKD group, the CKD (odds ratio [OR], 4.69; 95% confidence interval [CI], 2.02–10.89) and dialysis (OR, 6.71; 95% CI, 1.63–27.73) groups had a high risk of in-hospital death. The dialysis group had a high risk of infection after shoulder arthroplasty compared with the CKD (subdistribution hazard ratio [SHR], 1.69; 95% CI, 1.07–2.69) and non-CKD (SHR, 1.76; 95% CI, 1.14–2.73) groups. The dialysis group showed higher risks of all-cause readmission and mortality than the CKD and non-CKD groups after a 3-month follow-up. In conclusion, CKD was associated with worse outcomes after shoulder arthroplasty. Compared with those without CKD, CKD patients had significantly increased readmission and mortality risks but did not have an increased risk of surgical complications, including superficial infection or implant removal. |
| first_indexed | 2024-03-10T11:45:23Z |
| format | Article |
| id | doaj.art-896978f208fa4c238d98538a0db3a25b |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T11:45:23Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-896978f208fa4c238d98538a0db3a25b2023-11-21T18:08:11ZengMDPI AGDiagnostics2075-44182021-05-0111582210.3390/diagnostics11050822Chronic Kidney Disease Is Associated with High Mortality Risk in Patients with Diabetes after Primary Shoulder Arthroplasty: A Nationwide Population-Based Cohort StudyMeng-Hao Lin0Su-Ju Lin1Liang-Tseng Kuo2Tien-Hsing Chen3Chi-Lung Chen4Pei-An Yu5Yao-Hung Tsai6Wei-Hsiu Hsu7Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi 613, TaiwanDivision of Nephrology, Department of Medicine, Chang Gung Memorial Hospital, Chiayi 613, TaiwanDivision of Sports Medicine, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi 613, TaiwanSchool of Medicine, Chang Gung University, Taoyuan 333, TaiwanDivision of sports medicine, Chang Gung Memorial Hospital, Chiayi 613, TaiwanDivision of sports medicine, Chang Gung Memorial Hospital, Chiayi 613, TaiwanDivision of sports medicine, Chang Gung Memorial Hospital, Chiayi 613, TaiwanDivision of Sports Medicine, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi 613, TaiwanThe number of diabetic patients with chronic kidney disease (CKD) undergoing shoulder arthroplasty is growing. This study aims to compare perioperative outcomes of shoulder arthroplasty in diabetic patients at different renal function stages. Between 1998 and 2013, a total of 4443 diabetic patients with shoulder arthroplasty were enrolled: 1174 (26%) had CKD without dialysis (CKD group), 427 (9%) underwent dialysis (dialysis group), and 3042 (68%) had no CKD (non-CKD group). Compared with the non-CKD group, the CKD (odds ratio [OR], 4.69; 95% confidence interval [CI], 2.02–10.89) and dialysis (OR, 6.71; 95% CI, 1.63–27.73) groups had a high risk of in-hospital death. The dialysis group had a high risk of infection after shoulder arthroplasty compared with the CKD (subdistribution hazard ratio [SHR], 1.69; 95% CI, 1.07–2.69) and non-CKD (SHR, 1.76; 95% CI, 1.14–2.73) groups. The dialysis group showed higher risks of all-cause readmission and mortality than the CKD and non-CKD groups after a 3-month follow-up. In conclusion, CKD was associated with worse outcomes after shoulder arthroplasty. Compared with those without CKD, CKD patients had significantly increased readmission and mortality risks but did not have an increased risk of surgical complications, including superficial infection or implant removal.https://www.mdpi.com/2075-4418/11/5/822shoulder arthroplastychronic kidney diseasedialysisdiabetes mellitusreadmissionmortality |
| spellingShingle | Meng-Hao Lin Su-Ju Lin Liang-Tseng Kuo Tien-Hsing Chen Chi-Lung Chen Pei-An Yu Yao-Hung Tsai Wei-Hsiu Hsu Chronic Kidney Disease Is Associated with High Mortality Risk in Patients with Diabetes after Primary Shoulder Arthroplasty: A Nationwide Population-Based Cohort Study Diagnostics shoulder arthroplasty chronic kidney disease dialysis diabetes mellitus readmission mortality |
| title | Chronic Kidney Disease Is Associated with High Mortality Risk in Patients with Diabetes after Primary Shoulder Arthroplasty: A Nationwide Population-Based Cohort Study |
| title_full | Chronic Kidney Disease Is Associated with High Mortality Risk in Patients with Diabetes after Primary Shoulder Arthroplasty: A Nationwide Population-Based Cohort Study |
| title_fullStr | Chronic Kidney Disease Is Associated with High Mortality Risk in Patients with Diabetes after Primary Shoulder Arthroplasty: A Nationwide Population-Based Cohort Study |
| title_full_unstemmed | Chronic Kidney Disease Is Associated with High Mortality Risk in Patients with Diabetes after Primary Shoulder Arthroplasty: A Nationwide Population-Based Cohort Study |
| title_short | Chronic Kidney Disease Is Associated with High Mortality Risk in Patients with Diabetes after Primary Shoulder Arthroplasty: A Nationwide Population-Based Cohort Study |
| title_sort | chronic kidney disease is associated with high mortality risk in patients with diabetes after primary shoulder arthroplasty a nationwide population based cohort study |
| topic | shoulder arthroplasty chronic kidney disease dialysis diabetes mellitus readmission mortality |
| url | https://www.mdpi.com/2075-4418/11/5/822 |
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