Skip to main content

Advertisement

Log in

Metabolic syndrome and shoulder arthroplasty: epidemiology and peri-operative outcomes

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

Little is known about metabolic syndrome in the peri-operative shoulder surgery setting. We sought to determine the prevalence of metabolic syndrome in patients undergoing shoulder arthroplasty, and to characterize its relationship with in-hospital adverse events, prolonged length of stay, and non-routine disposition.

Methods

Using discharge records from the 2002–2011 Nationwide Inpatient Sample, temporal trends were assessed and multivariable logistic regression modeling was used to measure the association of metabolic syndrome with peri-operative outcomes.

Results

The prevalence of metabolic syndrome increased by 257 % from 2002 to 2011 (4.2 to 15.0 %). Metabolic syndrome was associated with increased aggregate morbidity (OR 1.34, 95 % CI 1.30–1.38), including acute renal failure (OR 1.51, 95 % CI 1.41–1.63), surgical site infection (OR 1.41, 95 % CI 1.16–1.71), myocardial infarction (OR 1.32, 95 % CI 1.12–1.55), acute posthemorrhagic anemia (OR 1.30, 95 % CI 1.26–1.34), and pulmonary embolism (OR 1.27, 95 % CI 1.06–1.52). It was also associated with prolonged hospital stay (OR 1.13, 95 % CI 1.10–1.16), non-homebound discharge (OR 1.29, 95 % CI 1.26–1.32), and increased blood transfusion use (OR 1.09, 95 % CI 1.06–1.13).

Conclusions

Metabolic syndrome is increasing rapidly among shoulder arthroplasty patients and is associated with considerable peri-operative morbidity and resource utilization. Greater awareness of metabolic syndrome and its health consequences may contribute to improvements in the peri-operative management of shoulder arthroplasty patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Galassi A, Reynolds K, He J (2006) Metabolic syndrome and risk of cardiovascular disease: a meta-analysis. Am J Med 119(10):812–819. doi:10.1016/j.amjmed.2006.02.031

    Article  CAS  PubMed  Google Scholar 

  2. Isomaa B, Almgren P, Tuomi T, Forsen B, Lahti K, Nissen M, Taskinen MR, Groop L (2001) Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care 24(4):683–689

    Article  CAS  PubMed  Google Scholar 

  3. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (2001) Executive summary of the third report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 285(19):2486–2497. doi:10.1001/jama.285.19.2486

    Article  Google Scholar 

  4. Carr DB, Utzschneider KM, Hull RL, Kodama K, Retzlaff BM, Brunzell JD, Shofer JB, Fish BE, Knopp RH, Kahn SE (2004) Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome. Diabetes 53(8):2087–2094

    Article  CAS  PubMed  Google Scholar 

  5. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F, American Heart Association, National Heart Lung, and Blood Institute (2005) Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 112(17):2735–2752. doi:10.1161/CIRCULATIONAHA.105.169404

    Article  PubMed  Google Scholar 

  6. Alberti G, Zimmet P, Shaw J, Grundy SM (2006) The IDF consensus worldwide definition of the Metabolic Syndrome. International Diabetes Federation, Brussels. www.idf.org/webdata/docs/IDF_Meta_def_final.pdf. Accessed 17 March 2016

  7. Aguilar M, Bhuket T, Torres S, Liu B, Wong RJ (2015) Prevalence of the metabolic syndrome in the United States, 2003–2012. JAMA 313(19):1973–1974. doi:10.1001/jama.2015.4260

    Article  CAS  PubMed  Google Scholar 

  8. Fontaine KR, Redden DT, Wang C, Westfall AO, Allison DB (2003) Years of life lost due to obesity. JAMA 289(2):187–193. doi:10.1001/jama.289.2.187

    Article  PubMed  Google Scholar 

  9. National Task Force on the Prevention and Treatment of Obesity (2000) Overweight, obesity, and health risk. Arch Intern Med 160(7):898–904. doi:10.1001/archinte.160.7.898

    Article  Google Scholar 

  10. Gonzalez Della Valle A, Chiu YL, Ma Y, Mazumdar M, Memtsoudis SG (2012) The metabolic syndrome in patients undergoing knee and hip arthroplasty: trends and in-hospital outcomes in the United States. J Arthroplasty 27(10):1743–1749 e1741. doi:10.1016/j.arth.2012.04.011

  11. Memtsoudis SG, Kirksey M, Ma Y, Chiu YL, Mazumdar M, Pumberger M, Girardi FP (2012) Metabolic syndrome and lumbar spine fusion surgery: epidemiology and perioperative outcomes. Spine (Phila Pa 1976) 37(11):989–995. doi:10.1097/BRS.0b013e31823a3a13

    Article  Google Scholar 

  12. Menendez ME, Neuhaus V, Bot AG, Ring D, Johnson AH (2014) The impact of metabolic syndrome on inpatient outcomes after isolated ankle fractures. Foot Ankle Int 35(5):463–470. doi:10.1177/1071100714524555

    Article  PubMed  Google Scholar 

  13. Kim SH, Wise BL, Zhang Y, Szabo RM (2011) Incresing incidence of shoulder arthroplasty in the United States. J Bone Joint Surg Am 93(24):2249–2254. doi:10.2106/JBJS.J.01994

    Article  PubMed  Google Scholar 

  14. Nelson FRT (2012) Osteoarthritis and metabolic syndrome. J Am Acad Orthop Surg 20:259–260. doi:10.5435/JAAOS-20-04-259

    Article  PubMed  Google Scholar 

  15. Zhuo Q, Yang W, Chen J, Wang Y (2012) Metabolic syndrome meets osteoarthritis. Nat Rev Rheumatol 8(12):729–737. doi:10.1038/nrrheum.2012.135

    Article  CAS  PubMed  Google Scholar 

  16. Sellam J, Berenbaum F (2013) Is osteoarthritis a metabolic disease? Joint Bone Spine 80(6):568–573. doi:10.1016/j.jbspin.2013.09.007

    Article  CAS  PubMed  Google Scholar 

  17. Millett PJ, Gobezie R, Boykin RE (2008) Shoulder osteoarthritis: diagnosis and management. Am Fam Physician 78(5):605–611

    PubMed  Google Scholar 

  18. Bozic KJ, Bashyal RK, Anthony SG, Chiu V, Shulman B, Rubash HE (2013) Is administratively coded comorbidity and complication data in total joint arthroplasty valid? Clin Orthop Relat Res 471(1):201–205. doi:10.1007/s11999-012-2352-1

    Article  Google Scholar 

  19. Ervin RB (2009) Prevalence of metabolic syndrome among adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index: United States, 2003–2006. Natl Health Stat Rep 13:1–7

    Google Scholar 

  20. Bass AR, Rodriguez T, Hyun G, Santiago FG, Kim JI, Woller SC, Gage BF (2015) Myocardial ischaemia after hip and knee arthroplasty: incidence and risk factors. Int Orthop 39(10):2011–2016. doi:10.1007/s00264-015-2853-0

    Article  PubMed  Google Scholar 

  21. Menendez ME, Memtsoudis SG, Opperer M, Boettner F, Gonzalez Della Valle A (2015) A nationwide analysis of risk factors for in-hospital myocardial infarction after total joint arthroplasty. Int Orthop 39(4):777–786. doi:10.1007/s00264-014-2502-z

    Article  PubMed  Google Scholar 

  22. Ando A, Sugaya H, Hagiwara Y, Takahashi N, Watanabe T, Kanazawa K, Itoi E (2013) Identification of prognostic factors for the nonoperative treatment of stiff shoulder. Int Orthop 37(5):859–864. doi:10.1007/s00264-013-1859-8

    Article  PubMed Central  Google Scholar 

  23. Chan YC, Cheng SW, Irwin MG (2008) Perioperative use of statins in noncardiac surgery. Vasc Health Risk Manag 4(1):75–81. doi:10.2147/VHRM.S1915

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Riess KP, Baker MT, Lambert PJ, Mathiason MA, Kothari SN (2008) Effect of preoperative weight loss on laparoscopic gastric bypass outcomes. Surg Obes Relat Dis 4(6):704–708. doi:10.1016/j.soard.2008.05.007

    Article  PubMed  Google Scholar 

  25. Lindström D, Sadr Azodi O, Wladis A, Tønnesen H, Linder S, Nåsell H, Ponzer S, Adami J (2008) Effects of a perioperative smoking cessation intervention on postoperative complications: a randomized trial. Ann Surg 248(5):739–745. doi:10.1097/SLA.0b013e3181889d0d

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Brent A. Ponce.

Ethics declarations

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Funding

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Murphy, A.B., Menendez, M.E., Watson, S.L. et al. Metabolic syndrome and shoulder arthroplasty: epidemiology and peri-operative outcomes. International Orthopaedics (SICOT) 40, 1927–1933 (2016). https://doi.org/10.1007/s00264-016-3214-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-016-3214-3

Keywords

Navigation