Metformin Use Is Associated with Fewer Complications in Patients with Type-2 Diabetes Undergoing Total Knee Arthroplasty: A Propensity Score-Matched Analysis.

摘要: BACKGROUND Diabetes is a well-established risk factor for complications following total knee arthroplasty (TKA), and the incidence of type-2 diabetes increasing. Metformin considered first-line therapy has been shown to reduce all-cause mortality possess anti-inflammatory properties. The impact metformin use as it relates outcomes TKA unknown. purpose this study was investigate relationship. METHODS This retrospective cohort using Truven MarketScan database. Adult patients undergoing unilateral, primary were identified. We included only with preoperative diagnosis established 2 cohorts based on status. Propensity score matching performed match who used those did not (1-to-1). Patients matched factors including age, sex, insulin status, other diabetic medications, comorbidities, complexity diabetes, smoking Regression analysis then examine 90-day outcomes. A subgroup 1-year revision rates. RESULTS After matching, there 32,186 in both group no-metformin group, resulting 64,372 patients. Baseline characteristics similar between groups. analysis, cohorts, demonstrated that had increased odds readmission (odds ratio [OR], 1.09 [95% confidence interval (CI), 1.04 1.15]; p < 0.001), emergency department presentation (OR, CI, 1.14]; extended length stay 1.12 1.06 periprosthetic joint infection 1.30 1.13 1.50]; deep vein thrombosis 1.17 1.26]; acute kidney injury 1.21 1.33]; hypoglycemic events 1.25 1.01 1.54]; = 0.039), 1.16 0.033). CONCLUSIONS appears be associated lower multiple resource utilization parameters, Given frequency which knowledge potential improve optimization protocols LEVEL OF EVIDENCE Therapeutic Level III. See Instructions Authors complete description levels evidence.