+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Optimal Timing of Glucose Measurements After Total Joint Arthroplasty



Optimal Timing of Glucose Measurements After Total Joint Arthroplasty



Journal of Arthroplasty 2019



Postoperative glucose levels after total joint arthroplasty are important to monitor as hyperglycemia has been linked to complications such as periprosthetic joint infection. The purposes of this study were to identify how postoperative glucose values vary during the perioperative period and determine the optimal time to check glucose levels to best evaluate for hyperglycemia. A retrospective study was conducted from September 2017 to September 2018 on 314 patients who underwent knee and hip arthroplasties. Blood glucose levels were collected immediately preoperatively, immediately postoperatively, at 5 PM on the day of surgery (DOS), at 9 PM on the DOS, and in the morning of postoperative day (POD) 1. The total number of hyperglycemic patients was assessed at 3 glucose thresholds: strict ≥ 126 mg/dL, intermediate ≥ 137 mg/dL, and lenient ≥ 180 mg/dL. Descriptive statistics were performed for each glucose time period, and adjusted comparisons were made between the mean glucose values and number of hyperglycemic patients at all time points. Mean (±95% confidence interval) glucose values were 105.7 ± 2.1 mg/dL preoperatively, 117.3 ± 2.5 mg/dL immediately postoperatively, 138.6 ± 4.3 mg/dL at 5 PM on the DOS, 142.9 ± 4.3 mg/dL at 9 PM on the DOS, and 116.7 ± 3.1 mg/dL in the morning of POD 1. Values measured at 5 PM and 9 PM were significantly higher than those measured at all other time points in both diabetics and nondiabetics (P < .001 for all). For all 3 hyperglycemia thresholds, the highest number of hyperglycemic patients was observed at 9 PM on the DOS: strict = 205 (65.3%) patients, intermediate = 177 (56.4%) patients; and lenient = 90 (28.7%) patients. Most patients who underwent total joint arthroplasty are hyperglycemic postoperatively, and 9 PM on the night of surgery may be the most sensitive time for detecting hyperglycemia in both diabetic and nondiabetic patients, in contrast to traditional POD 1 levels.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 066446831

Download citation: RISBibTeXText

PMID: 30704771

DOI: 10.1016/j.arth.2019.01.004


Related references

Optimal timing of wound drain removal following total joint arthroplasty. Journal of Arthroplasty 10(2): 185-189, 1995

What Is the Optimal Criteria to Use for Detecting Periprosthetic Joint Infections Before Total Joint Arthroplasty?. Journal of Arthroplasty 33(7s): S201-S204, 2018

Incidence and timing of myocardial infarction after total joint arthroplasty. Journal of Arthroplasty 21(6): 874-877, 2006

Optimal release timing of temporary drain clamping after total knee arthroplasty. Journal of Orthopaedic Surgery and Research 12(1): 47, 2017

Optimal Timing for Hemoglobin Concentration Determination after Total Knee Arthroplasty: Day 1 versus Day 2. Knee Surgery and Related Research 29(1): 52-56, 2017

Intraoperative Measurements of Joint Line Changes Using Computer Navigation Do Not Correlate With Postoperative Radiographic Measurements in Total Knee Arthroplasty. Journal of Arthroplasty 32(1): 61-65, 2016

What Is the Timing of General Health Adverse Events That Occur After Total Joint Arthroplasty?. Clinical Orthopaedics and Related Research 475(12): 2952-2959, 2017

CORR Insights ® : What Is the Timing of General Health Adverse Events That Occur After Total Joint Arthroplasty?. Clinical Orthopaedics and Related Research 475(12): 2960-2962, 2017

Trapezium anatomy as a radiographic reference for optimal cup orientation in total trapeziometacarpal joint arthroplasty. Journal of Hand Surgery, European Volume 41(9): 939-943, 2016

AB0844Determinants of Returning to Work 12 Months After Total Joint Surgery: Differences Between Total Hip Arthroplasty and Total Knee Arthroplasty. Annals of the Rheumatic Diseases 74(Suppl 2): 1182.3-1183, 2015

Optimal Multimodal Analgesia Treatment Recommendations for Total Joint Arthroplasty: A Critical Analysis Review. Jbjs Reviews 6(6): E7, 2018

Home Discharge After Primary Elective Total Joint Arthroplasty: Postdischarge Complication Timing and Risk Factor Analysis. Journal of Arthroplasty 32(2): 375-380, 2016

Postoperative Blood Glucose Levels Predict Infection After Total Joint Arthroplasty. Journal of Bone and Joint Surgery. American Volume 100(16): 1423-1431, 2018

Increased Postoperative Glucose Variability Is Associated with Adverse Outcomes Following Total Joint Arthroplasty. Journal of Bone and Joint Surgery. American Volume 100(13): 1110-1117, 2018

Morbidly obese, diabetic, younger, and unilateral joint arthroplasty patients have elevated total joint arthroplasty infection rates. Journal of Arthroplasty 24(6 Suppl): 84-88, 2010