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Obesity, Diabetes Raise Joint Replacement Risks

Study finds more complications in hypertensive patients, too

WEDNESDAY, June 1, 2005 (HealthDay News) -- Diabetes, hypertension and obesity raise risks for complications following major joint replacement surgery, Duke University researchers report.

Researchers analyzed a database of nearly 1 million Americans who had undergone major joint replacement surgery of the hip, knee or shoulder and found that 3.7 percent of obese patients suffered in-hospital complications, compared with 2.6 percent of patients who were not obese.

Complication rates were 2.8 percent for patients with high blood pressure, or hypertension, compared with 2.6 for patients without hypertension. Also, 2.9 percent of patients with diabetes had complications, compared with 2.6 of those without diabetes.

Obese patients were at a 45 percent greater likelihood of a "nonroutine" discharge from hospital, while those with diabetes faced a 30 percent boost in their likelihood for complications. That increase in risk rose to 75 percent for patients who were both obese and diabetic.

"Nonroutine" discharge refers to cases where patients are sent to another facility for further care, such as short-term hospitals, intermediate care facilities or home health care.

The findings appear in the June 1 issue of the journal Clinical Orthopaedics and Related Research.

The study authors recommended that doctors evaluate treating these at-risk patients before surgery in order to control their blood sugar, lower blood pressure and prevent blood clot formation to reduce the risk of post-surgical complications.

"The results of our study should help surgeons to more accurately predict which of their patients are most likely to have adverse outcomes after their surgery," study first author Dr. Nitin Jain said in a prepared statement.

"With this knowledge, surgeons should not only be able to better counsel their patients before surgery, but also consider strategies during and after surgery to ensure better outcomes. However, the risks and benefits of a joint replacement procedure should be weighed by surgeons on an individual patient basis," Jain said.

More information

The American Academy of Orthopaedic Surgeons has more about joint replacement.

SOURCE: Duke University Medical Center, news release, June 1, 2005
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