Comparative morbidity and mortality following primary total shoulder arthroplasty in octogenarians with and without diabetes in the United States.

Background: Diabetic patients face higher risks of postoperative medical complications and surgical issues in various orthopedic surgeries. It is essential to understand if these risks differ in the older geriatric population. Therefore, this study sought to assess whether diabetic octogenarians exhibit elevated thirty-day morbidity and mortality risks in comparison to non-diabetic octogenarians after primary total shoulder arthroplasty (TSA).

Methods: Data were obtained from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Octogenarians who received primary TSA from 2006 to 2019 were categorized into diabetic and non-diabetic groups. Demographic information, additional medical conditions, and postoperative complications were gathered and analyzed between the two groups using both univariate statistics and multivariate logistic regression.

Results: After adjusting for multiple variables, diabetic octogenarians exhibited a higher risk of bleeding requiring blood transfusions (OR 1.52; p = 0.032) and prolonged hospital stays (OR 1.41; p = 0.001) compared to their non-diabetic counterparts. No significant difference in mortality rates was observed between the two cohorts (p = 0.173).

Conclusion: Primary TSA appears to be a generally safe procedure for diabetic octogenarians, though these patients demonstrate increased risks for blood transfusions and prolonged hospital stays compared to non-diabetes.

Level Of Evidence: III.