title: Trends 2001 to 2008 in incidence and immediate postoperative outcomes for major joint replacement among Spanish adults suffering diabetes.
abstract: OBJECTIVE
  To analyze the trend of incidence rates of primary total knee (TKA) and primary total hip arthroplasty (THA) due to osteoarthritis among Spanish adults suffering diabetes (type-1 and 2) from 2001 to 2008 and analyze in-hospital mortality (IHM), length of stay (LOS) and hospital charges compared with non-diabetic patients.
  
  
  METHODS
  From the Spanish National Hospital Database, we selected 250,205 patients with TKA and 122,926 patients with THA; 12 and 9% of patients undergoing TKA and THA, respectively, were diabetes sufferers, of them, 1.6% was classified as type 1 in each procedure.
  
  
  RESULTS
  Incidence of both procedures increased over the period, but diabetic patients had a larger increment compared with non-diabetic patients. The ratio of diabetes versus non-diabetes sufferers undergoing TKA increased from 0.10 in 2001 to 0.16 in 2008 and from 0.08 to 0.11 for THA. Unadjusted IHM was higher among type-2 diabetic adults in both procedures. IHM rate did not show a secular time trend among diabetic patients. LOS was significantly longer among patients with diabetes type-1 and 2 undergoing THP when compared with non-diabetic patients. Hospital charges were higher among diabetic versus non-diabetic patients for both procedures showing a significant increase over the period.
  
  
  CONCLUSIONS
  Immediate postoperative outcomes for major joint replacement are worse among persons with than without diabetes, and prevalence of diabetes is increasing in patients undergoing these surgeries.
authors: Preventive Medicine Unit, Rey Juan Carlos University, Av.Atenas, 28922 Alcorcón, Spain. marhuedo@hotmail.com
authors: Maria A
authors: MA
authors: Martinez-Huedo
authors: Manuel
authors: M
authors: Villanueva
authors: Ana Lopez
authors: AL
authors: de Andres
authors: Valentin
authors: V
authors: Hernandez-Barrera
authors: Pilar
authors: P
authors: Carrasco-Garrido
authors: Angel
authors: A
authors: Gil
authors: David
authors: D
authors: Martinez
authors: Rodrigo
authors: R
authors: Jiménez-Garcia
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000401:mortality / Q000706:statistics & numerical data* / Q000639:trends; D019645:Arthroplasty, Replacement, Knee / Q000401:mortality / Q000706:statistics & numerical data* / Q000639:trends; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000601:surgery; D020370:Osteoarthritis, Knee / Q000601:surgery; D013030:Spain; D016896:Treatment Outcome