Impact of diabetic kidney disease on in-hospital complications and healthcare utilization following primary shoulder arthroplasty: a national database analysis.
5 affiliations
- 1Department of Sports Medicine, Affiliated Meizhou Hospital of Shantou University Medical College, No. 63, Huang Tang Road, Meizhou, 514031, China.
- 2Shantou University Medical College, Shantou, China.
- 3Institute of Basic Medical Sciences, Affiliated Meizhou Hospital of Shantou University Medical College, Meizhou, China.
- 4Department of Sports Medicine, Affiliated Meizhou Hospital of Shantou University Medical College, No. 63, Huang Tang Road, Meizhou, 514031, China. [email protected].
- 5Shantou University Medical College, Shantou, China. [email protected].
Abstract
Background
Shoulder arthroplasty (SA) is an established treatment for advanced shoulder disorders; however, its outcomes can be influenced by various comorbidities, particularly diabetic kidney disease (DKD). DKD, a combination of diabetes mellitus and renal dysfunction, may present unique challenges in the perioperative setting. This study examined the association between DKD on in-hospital complications and healthcare utilization following primary SA.Methods
A retrospective cohort study was conducted using the National Inpatient Sample (NIS) database, encompassing patients who underwent primary SA (including anatomic total shoulder arthroplasty, reverse total shoulder arthroplasty, and hemiarthroplasty) between 2018 and 2022. Patients with and without DKD were compared regarding demographic and hospital characteristics, preoperative comorbidities, postoperative complications, length of stay (LOS), and hospital charges. Propensity score matching was utilized to balance confounders between groups.Results
The cohort consisted of 96,499 patients, with 2,576 (2.7%) diagnosed with DKD. In the matched cohort, DKD was associated with higher odds of acute renal failure, blood transfusions, genitourinary complications, and joint dislocation. Furthermore, DKD was associated with a longer LOS (median 2.0 vs. 1.0 days) and higher total hospital charges ($68,964.50 vs. $65,667.50, p < 0.001). Multivariate analysis confirmed these findings, with DKD patients showing significantly worse postoperative outcomes, including an increased risk of in-hospital complications and extended hospitalization.Conclusion
DKD was associated with a higher likelihood of several in-hospital complications and greater healthcare utilization following primary SA. These findings emphasize the need for careful preoperative assessment and tailored perioperative management for patients with DKD, particularly in relation to renal function, blood transfusion, and potential genitourinary issues. Further studies are required to evaluate long-term outcomes and the specific role of DKD in shoulder-specific complications.Level of evidence
Level III; Retrospective cohort comparison using large database prognosis study.
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BibTeX
@article{guo2026impact,
title = {{Impact of diabetic kidney disease on in-hospital complications and healthcare utilization following primary shoulder arthroplasty: a national database analysis.}},
author = {Yuanqiu Guo and Xia Li and Yunhao Wang},
journal = {BMC surgery},
year = {2026},
month = aug,
doi = {10.1186/s12893-026-04107-4},
url = {https://europepmc.org/article/MED/42972359},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Impact of diabetic kidney disease on in-hospital complications and healthcare utilization following primary shoulder arthroplasty: a national database analysis.
AU - Yuanqiu Guo
AU - Xia Li
AU - Yunhao Wang
PY - 2026
DA - 2026/08/05
JO - BMC surgery
DO - 10.1186/s12893-026-04107-4
UR - https://europepmc.org/article/MED/42972359
AB - Background Shoulder arthroplasty (SA) is an established treatment for advanced shoulder disorders; however, its outcomes can be influenced by various comorbidities, particularly diabetic kidney disease (DKD). DKD, a combination of diabetes mellitus and renal dysfunction, may present unique challenges in the perioperative setting. This study examined the association between DKD on in-hospital complications and healthcare utilization following primary SA.Methods A retrospective cohort study was conducted using the National Inpatient Sample (NIS) database, encompassing patients who underwent primary SA (including anatomic total shoulder arthroplasty, reverse total shoulder arthroplasty, and hemiarthroplasty) between 2018 and 2022. Patients with and without DKD were compared regarding demographic and hospital characteristics, preoperative comorbidities, postoperative complications, length of stay (LOS), and hospital charges. Propensity score matching was utilized to balance confounders between groups.Results The cohort consisted of 96,499 patients, with 2,576 (2.7%) diagnosed with DKD. In the matched cohort, DKD was associated with higher odds of acute renal failure, blood transfusions, genitourinary complications, and joint dislocation. Furthermore, DKD was associated with a longer LOS (median 2.0 vs. 1.0 days) and higher total hospital charges ($68,964.50 vs. $65,667.50, p < 0.001). Multivariate analysis confirmed these findings, with DKD patients showing significantly worse postoperative outcomes, including an increased risk of in-hospital complications and extended hospitalization.Conclusion DKD was associated with a higher likelihood of several in-hospital complications and greater healthcare utilization following primary SA. These findings emphasize the need for careful preoperative assessment and tailored perioperative management for patients with DKD, particularly in relation to renal function, blood transfusion, and potential genitourinary issues. Further studies are required to evaluate long-term outcomes and the specific role of DKD in shoulder-specific complications.Level of evidence Level III; Retrospective cohort comparison using large database prognosis study.
SN - 1471-2482
ER -