title: Preadmission hyperglycemia is an independent risk factor for in-hospital symptomatic pulmonary embolism after major orthopedic surgery.
abstract: We investigate whether preadmission hyperglycemia is a risk factor for developing in-hospital symptomatic pulmonary embolism after major orthopedic surgery. Medical records of patients undergoing total hip or total knee arthroplasty from January 2001 to April 2006 were reviewed. The incidence of PE was 1.47% (107/7282 patients). Multivariate analysis showed that preadmission blood glucose (BG) of at least 200 mg/dL independently increased the risk of pulmonary embolism by 3.19 times (P = .015), when compared with patients with BG of less than 110 mg/dL. Other significant risks factors were age (>or=70 years old), body mass index of more than 30 kg/m(2), and congestive heart failure. Total knee had 2.19 times (P = .002) more risk than total hip arthroplasty and bilateral procedure increased the risk by 2.13 times (P = .015). Sex, American Society of Anesthesiologists status, duration of surgery, malignancy, pulmonary disease, hypertension, diabetes mellitus, dyslipidemia, sleep apnea, and stroke were not found to be significant risk factors for pulmonary embolism.
authors.affiliation: Department of Anesthesiology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
authors.forename: Boris
authors.initials: B
authors.lastname: Mraovic
authors.forename: Brian R
authors.initials: BR
authors.lastname: Hipszer
authors.forename: Richard H
authors.initials: RH
authors.lastname: Epstein
authors.forename: Edward C
authors.initials: EC
authors.lastname: Pequignot
authors.forename: Javad
authors.initials: J
authors.lastname: Parvizi
authors.forename: Jeffery I
authors.initials: JI
authors.lastname: Joseph
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006943:Hyperglycemia / Q000150:complications* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011655:Pulmonary Embolism / Q000209:etiology*; D012307:Risk Factors