The Effects of Dexamethasone in Diabetic Patients Undergoing Primary Total Joint Arthroplasty.
Date
2021-09
Journal Title
Journal ISSN
Volume Title
Repository Usage Stats
views
downloads
Citation Stats
Attention Stats
Abstract
Dexamethasone reduces postoperative pain and nausea, with no evidence of increased rate of infection in total joint arthroplasty. However, the effects of dexamethasone on diabetic patients undergoing total joint arthroplasty remain relatively unexplored. The purpose of this study was to examine the effects of dexamethasone on postoperative blood glucose levels, prosthetic joint infections (PJIs), and 90-day hospital returns in diabetic patients following total joint arthroplasty. Retrospective analysis was performed on 228 adult patients with a diagnosis of diabetes who underwent primary total joint arthroplasty. Patients were stratified by intraoperative dexamethasone administration. In total, 173 (75.9%) patients received intraoperative dexamethasone, with no differences in demographic variables compared with patients who did not receive dexamethasone. There was no significant difference in PJIs or 90-day hospital returns. Patients who received dexamethasone had significantly increased blood glucose concentration on Postoperative Day 1 and were significantly more likely to have blood glucose levels exceeding 180 g/dl. Although postoperative blood glucose levels were significantly increased, it is unclear what effects, if any, transient hyperglycemia may have on outcomes. The outcomes of this study support perioperative administration of dexamethasone in diabetic patients.
Type
Department
Description
Provenance
Subjects
Citation
Permalink
Published Version (Please cite this version)
Publication Info
Harding, Margaret M, Sonia E Xavier, Thorsten M Seyler and Sean P Ryan (2021). The Effects of Dexamethasone in Diabetic Patients Undergoing Primary Total Joint Arthroplasty. Orthopedic nursing, 40(5). pp. 301–304. 10.1097/nor.0000000000000790 Retrieved from https://hdl.handle.net/10161/34328.
This is constructed from limited available data and may be imprecise. To cite this article, please review & use the official citation provided by the journal.
Collections
Scholars@Duke
Margaret Harding
Thorsten Markus Seyler
Based on a recent market research survey, the U.S. demand for implantable medical devices is forecast to increase 7.7% annually to $52 billion in 2015. While orthopedic implants remain the largest segment, implantable devices are frequently used in urology, cardiovascular specialties, neurology, gynecology, and otolaryngology. With the increased usage of implantable devices, the number of biofilm-associated infections has emerged as a significant clinical problem because biofilms are often resistant to traditional antimicrobial therapy and difficult to eradicate. In fact, biofilm cells show as much as a 1000-fold more resistance to traditional antimicrobial therapy than their planktonic cell counterparts and biofilm-based microbial infections make up to 80% of all infections in patients, leading the CDC to declare biofilms to be one of the most important medical hurdles of the century.
Since microbial biofilms are a major clinical concern, my lab seeks to (a) advance the ability to diagnose biofilm-associated infections, (b) understanding of the formation of biofilms, and (c) develop/use novel treatment approaches to prevent and treat biofilm-associated infections.
Sean Ryan
Dr. Sean Ryan is an Adult Reconstruction surgeon in the Division of Orthopaedic Surgery. He specializes in hip and knee primary and revision arthroplasty as well as periacetabular osteotomies for hip dysplasia. His research interests include patient outcomes, implant survivorship, implant design, periprosthetic joint infection, and instability.
Unless otherwise indicated, scholarly articles published by Duke faculty members are made available here with a CC-BY-NC (Creative Commons Attribution Non-Commercial) license, as enabled by the Duke Open Access Policy. If you wish to use the materials in ways not already permitted under CC-BY-NC, please consult the copyright owner. Other materials are made available here through the author’s grant of a non-exclusive license to make their work openly accessible.