Infection Risk and Day-of-Surgery Blood Glucose Levels

A new tool to help make good decisions for patients undergoing arthroplasty

What’s the Claim?

A well-designed large-database study found that elevated blood glucose on the morning of a THA was a serious risk factor for major complications, especially prosthetic joint infection (PJI). The authors used a rigorous and methodologically intense approach to set a threshold of a clinically meaningful increase in odds of PJI (they chose 1.5x for the lower bound of the confidence interval) and found:

  • Patients with diabetes whose spot blood glucose level the morning of THA surgery was >277 mg/dL had a 2.6-fold odds increase of PJI (95% CI 1.5 to 4.7)
  • Patients without diabetes whose blood glucose was >193 had increased risk as well (OR 1.7 [95% CI 1.1 to 2.5])

How’s It Stack Up?