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Background Knee arthroplasty is one of the most common reasons for hospitalizations in the United States. Diabetes mellitus is thought to be associated with adverse perioperative outcomes. We sought to demonstrate the effect of comorbid diabetes on hospitalizations involving patients with knee osteoarthritis who had knee arthroplasty. Materials and methods Data was obtained from the Nationwide Inpatient Sample (NIS) for 2016 and 2017. ICD-10 codes were used to obtain a cohort of patient who were principally admitted for knee osteoarthritis who underwent knee arthroplasty. The patients were further divided according to diabetic status. The primary outcome compared inpatient mortality. Secondary outcomes included mean length of hospital stay, total hospital charges, presence of secondary diagnoses on discharge of acute kidney injury, surgical site infection, sepsis, thromboembolic events, non-ST segment elevation myocardial infarction (NSTEMI). Results Patients with diabetes mellitus had a lower adjusted odds ratio for mortality (aOR: 0.45 95% CI: 0.221-0.920, p = 0.029), with no significant difference in total hospital charges and length of hospital stay. Interestingly, patients with diabetes had lower odds of NSTEMI; 0.53 (95% CI: 0.369-0.750, p < 0.001) sepsis; 0.64 (95% CI: 0.449-0.924, p = 0.017) and DVT; 0.67 (95% CI: 0.546-0.822, p < 0.001). Conclusion Uncomplicated diabetes mellitus is not associated with adverse outcomes in patients hospitalized with knee osteoarthritis who had knee arthroplasty.

This study aimed to compare the outcomes of patients primarily admitted for atrial fibrillation (AF) with and without a secondary diagnosis of rheumatoid arthritis (RA). The primary outcome of interest was inpatient mortality. Hospital length of stay (LOS), total hospital charges, and odds of undergoing ablation and pharmacologic cardioversion were the secondary outcomes of interest.

Objectives: This study aims to compare the outcomes of patients admitted primarily for acute coronary syndrome (ACS) with and without a secondary diagnosis of rheumatoid arthritis (RA). Methods: Data were abstracted from the National Inpatient Sample (NIS) 2016 and 2017 Database. The NIS was searched for hospitalizations of adult patients with ACS as principal diagnoses, with and without RA as a secondary diagnosis. The primary outcome was inpatient mortality. Secondary outcomes were hospitalization characteristics and cardiovascular therapies. Multivariate logistic and linear regression analysis were used accordingly to adjust for confounders. Results: There were over 71 million discharges included in the combined 2016 and 2017 NIS database. Out of 1.3 million patients with ACS, 22,615 (1.7%) had RA. RA group was older (70.4 vs 66.8 years, P<0.001) as compared to the non-RA group, and had more females (63.7% vs 37.7%, P<0.0001). Patients with RA had a 16% reduced risk of in-hospital mortality: odds ratio (OR) 0.84, 95% confidence interval (CI) (0.72-0.99), P=0.034; less odds of undergoing intraaortic balloon pump (IABP): OR 0.78, 95% CI (0.64-0.95), P=0.015; and 0.18 days shorter hospital length of stay (LOS): 95% CI (0.32-0.05), P=0.009. However, odds of undergoing percutaneous coronary intervention with drug-eluting stent (PCI DES) at OR 1.14, 95% CI (1.07-1.23), P<0.0001 was significantly higher in the RA group compared to ACS without RA. Conclusions: Patients admitted for ACS with co-existing RA had lower adjusted inpatient mortality, less odds of undergoing IABP, shorter adjusted LOS, and greater adjusted odds of undergoing PCI DES compared to those without RA.

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