Observational studyBMJ open2024
Association between diabetes mellitus and total hip arthroplasty outcomes: an observational study using the US National Inpatient Sample.
Observational study in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Outcomes of Glucagon-Like-Peptide-1 Receptor Agonists (GLP-1A) and Patients Undergoing Total Hip Arthroplasty (THA): A Systematic Review and Meta-Analysis.The Iowa orthopaedic journal · 2026Pooled it
- [2024 American Academy of Orthopaedic Surgeons (AAOS) Clinical Practice Guideline: Management of Osteoarthritis of the Hip (summary) interpretation].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2025Guideline
- Risk factors for perioperative blood transfusion in total hip arthroplasty: a meta-analysis.BMC musculoskeletal disorders · 2025Pooled it
- Adverse in-hospital outcomes after shoulder arthroplasty by diabetes status: a retrospective study using the national inpatient sample.Frontiers in medicine · 2026Article
- Hypothyroidism is associated with higher healthcare utilisation and higher need for blood transfusion after primary total knee arthroplasty (TKA) in patients with osteoarthritis: A National Inpatient Sample analysis.Journal of experimental orthopaedics · 2026Article
- Neurologic and psychiatric disorders as risk factors following hip arthroplasty: results from the German arthroplasty registry.International orthopaedics · 2025Article
- Diabetes and total knee arthroplasty: A nationwide analysis of complications, hospitalization outcomes and revision burden.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
objectivesTo investigate the association of diabetes with postoperative outcomes in patients undergoing primary total hip arthroplasty (THA).
designRetrospective cohort study using data from the US National Inpatient Sample (NIS).
settingStudy cohort was hospitalisations for primary THA in the USA, identified from the 2016-2020 NIS.
participantsWe identified 2 467 215 adults in the 2016-2020 NIS who underwent primary THA using International Classification of Diseases, 10th Revision codes. Primary THA hospitlizations were analysed as the overall group and also stratified by the underlying primary diagnosis for THA. OUTCOME MEASURES: Outcome measures of interest were the length of hospital stay>the median, total hospital charges>the median, inpatient mortality, non-routine discharge, need for blood transfusion, prosthetic fracture, prosthetic dislocation and postprocedural infection, including periprosthetic joint infection, deep surgical site infection and postprocedural sepsis.
resultsAmong 2 467 215 patients who underwent primary THA, the mean age was 68.7 years, 58.3% were female, 85.7% were white, 61.7% had Medicare payer and 20.4% had a Deyo-Charlson index (adjusted to exclude diabetes mellitus) of 2 or higher. 416 850 (17%) patients had diabetes. In multivariable-adjusted logistic regression in the overall cohort, diabetes was associated with higher odds of a longer hospital stay (adjusted OR (aOR) 1.38; 95% CI 1.35 to 1.41), higher total charges (aOR 1.11; 95% CI 1.09 to 1.13), non-routine discharge (aOR 1.18; 95% CI 1.15 to 1.20), the need for blood transfusion (aOR 1.19; 95% CI 1.15 to 1.23), postprocedural infection (aOR 1.62; 95% CI 1.10 to 2.40) and periprosthetic joint infection (aOR 1.91; 95% CI 1.12 to 3.24). We noted a lack of some associations in the avascular necrosis and inflammatory arthritis cohorts (p>0.05).
conclusionDiabetes was associated with increased healthcare utilisation, blood transfusion and postprocedural infection risk following primary THA. Optimisation of diabetes with preoperative medical management and/or institution of specific postoperative pathways may improve these outcomes. Larger studies are needed in avascular necrosis and inflammatory arthritis cohorts undergoing primary THA.
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