Trends 2001 to 2008 in incidence and immediate postoperative outcomes for major joint replacement among Spanish adults suffering diabetes.

OBJECTIVES: To analyze the trend of incidence rates of primary total knee (TKA) and primary total hip arthroplasty (THA) due to osteoarthritis among Spanish adults suffering diabetes (type-1 and 2) from 2001 to 2008 and analyze in-hospital mortality (IHM), length of stay (LOS) and hospital charges compared with non-diabetic patients.

METHODS: From the Spanish National Hospital Database, we selected 250,205 patients with TKA and 122,926 patients with THA; 12 and 9% of patients undergoing TKA and THA, respectively, were diabetes sufferers, of them, 1.6% was classified as type 1 in each procedure.

RESULTS: Incidence of both procedures increased over the period, but diabetic patients had a larger increment compared with non-diabetic patients. The ratio of diabetes versus non-diabetes sufferers undergoing TKA increased from 0.10 in 2001 to 0.16 in 2008 and from 0.08 to 0.11 for THA. Unadjusted IHM was higher among type-2 diabetic adults in both procedures. IHM rate did not show a secular time trend among diabetic patients. LOS was significantly longer among patients with diabetes type-1 and 2 undergoing THP when compared with non-diabetic patients. Hospital charges were higher among diabetic versus non-diabetic patients for both procedures showing a significant increase over the period.

CONCLUSIONS: Immediate postoperative outcomes for major joint replacement are worse among persons with than without diabetes, and prevalence of diabetes is increasing in patients undergoing these surgeries.