Table 2.
The effects of different patient- and operation-related factors on the incidence of hyperglycemia and severe hyperglycemia. The odds ratios (ORs) were adjusted for age, sex, operated joint (hip or knee), and the American Society of Anesthesiologists risk score
| Hyperglycemia Adjusted |
Severe hyperglycemia Adjusted |
||||
|---|---|---|---|---|---|
| n | n (%) | OR (95% CI) | n (%) | OR (95% CI) | |
| Gender | |||||
| Male | 67 | 26 (39) | 1 | 17 (25) | 1 |
| Female | 124 | 50 (40) | 1.4 (0.70–2.7) | 31 (25) | 1.3 (0.60–2.6) |
| Age a | 1.0 (0.99–1.1) | 1.0 (0.97–1.1) | |||
| < 55 years | 20 | 5 (25) | 1 | 4 (20) | 1 |
| 55–64 years | 68 | 20 (29) | 0.7 (0.22–2.5) | 10 (15) | 0.4 (0.11–1.6) |
| 65–74 years | 72 | 32 (44) | 1.0 (0.79–7.3) | 20 (28) | 0.7 (0.18–2.7) |
| ≥ 75 years | 31 | 19 (61) | 1.7 (0.42–6.7) | 14 (45) | 1.2 (0.28–5.5) |
| ASA risk score | |||||
| I | 16 | 1 (6) | 1 | 1 (6) | 1 |
| II | 92 | 27 (29) | 5.0 (0.61–41) | 15 (16) | 2.6 (0.31–22) |
| III | 82 | 48 (59) | 15 (1.8–125) | 32 (39) | 8.0 (0.93–69) |
| IV | 1 | 0 (0) | - | 0 (0) | - |
| Body mass index, kg/m2 a | 1.0 (0.94–1.1) | 1.0 (0.95–1.1) | |||
| < 25.0 | 28 | 12 (43) | 1 | 9 (32) | 1 |
| 25.0–29.9 | 71 | 27 (38) | 1.0 (0.37–2.5) | 11 (16) | 0.4 (0.14–1.2) |
| 30.0–34.9 | 60 | 24 (40) | 1.0 (0.36–2.6) | 19 (32) | 1.1 (0.39–3.0) |
| 35.0–39.9 | 20 | 8 (40) | 1.0 (0.28–3.7) | 6 (30) | 1.0 (0.26–3.9) |
| ≥ 40.0 | 12 | 5 (42) | 0.8 (0.19–3.8) | 3 (25) | 0.6 (0.12–3.3) |
| State of glucose metabolism | |||||
| Normal | 91 | 20 (22) | 1 | 10 (11) | 1 |
| IFG and/or IGT | 47 | 17 (36) | 1.8 (0.79–4.1) | 7 (15) | 1.4 (0.48–4.2) |
| Newly diagnosed diabetes | 17 | 8 (47) | 2.4 (0.79–7.5) | 3 (18) | 1.5 (0.34–6.1) |
| Previously diagnosed diabetes | 36 | 31 (86) | 18 (5.7–59) | 28 (78) | 29 (9.1–97) |
| Metabolic syndrome | |||||
| Without | 106 | 31 (29) | 1 | 18 (17) | 1 |
| With | 85 | 45 (53) | 2.2 (1.1–4.2) | 30 (35) | 2.1 (1.03–4.4) |
| Smoking | |||||
| No | 169 | 67 (40) | 1 | 42 (25) | 1 |
| Yes | 22 | 9 (41) | 1.59 (0.52–4.83) | 6 (27) | 1.6 (0.52–4.8) |
| Preoperative anemia | |||||
| Without | 181 | 69 (38) | 1 | 44 (24) | 1 |
| With | 10 | 7 (70) | 3.9 (0.91–17) | 4 (40) | 2.0 (0.50–8.1) |
| Renal function | |||||
| Normal | 100 | 39 (39) | 1 | 26 (26) | 1 |
| Mild insufficiency | 74 | 29 (39) | 0.6 (0.28–1.2) | 15 (20) | 0.5 (0.22–1.2) |
| Moderate insufficiency | 17 | 8 (47) | 0.5 (0.12–1.6) | 7 (41) | 1.0 (0.27–3.7) |
| Operation-related data | |||||
| Laterality | |||||
| Unilateral | 170 | 72 (42) | 1 | 45 (27) | 1 |
| Bilateral | 21 | 4 (19) | 0.5 (0.14–1.5) | 3 (14) | 0.7 (0.17–2.5) |
| Time of induction of anesthesia | |||||
| Before 10 am | 95 | 41 (43) | 1 | 25 (26) | 1 |
| After 10 am | 96 | 35 (37) | 0.7 (0.40–1.4) | 23 (24) | 0.9 (0.43–1.7) |
| Duration of surgery × 10 min a | 191 | 0.95 (0.86–1.1) | 1.03 (0.92–1.2) | ||
| Blood loss × 100 mL a | 191 | 1.0 (0.88–1.1) | 1.0 (0.90–1.2) | ||
| Tourniquet time × 10 min (incl. knees only) a | 117 | 1.0 (0.84–1.2) | 1.2 (0.99–1.5) | ||
| Cement used for fixationb | |||||
| None | 83 | 36 (43) | 1 | 21 (25) | 1 |
| Any | 108 | 40 (37) | 0.8 (0.37–1.6) | 27 (25) | 1.3 (0.56–2.9) |
| Blood transfusion | |||||
| None | 167 | 63 (38) | 1 | 38 (23) | 1 |
| Any | 24 | 13 (54) | 1.3 (0.48–3.3) | 10 (42) | 1.8 (0.66–4.7) |
| Closed suction drains | |||||
| None | 77 | 31 (40) | 1 | 21 (27) | 1 |
| Any | 114 | 45 (40) | 2.0 (0.67–5.8) | 27 (24) | 1.4 (0.44–4.2) |
a
Continuous
b
Fully cementless vs. fully cemented and hybrid joint replacements.
ASA: American Society of Anesthesiologists; IFG: increased fasting glucose;
IGT: impaired glucose tolerance.