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Type 2 Diabetes is Associated with an Increased Risk of 90-day Postoperative Medical Complications and Reoperation Following Cubital Tunnel Release: A Propensity Matched Comparison
Cameron Bowers, BS, Philong Nguyen, BS, Carolyn Henein, MS, Joshua Wang, MS; William M Weiss, MD
University of Texas Medical Branch, Galveston, TX
Introduction: Previous research has explored postoperative complications following cubital tunnel release (CuTR) as well postoperative complications in patients with type 2 diabetes mellitus (T2DM) undergoing orthopedic surgery procedures such as carpal tunnel release. However, there are limited studies that assess medical complications and rates of reoperation in patients with T2DM undergoing CuTR. This study aims to explore these outcomes in patients with T2DM compared to non-diabetic patients.
Methods: A retrospective query of the TriNetX database was performed to identify patients who underwent cubital tunnel release and had a previous diagnosis of T2DM using Current Procedural Terminology (CPT) and International Classification of Diseases, 10
th Revision (ICD-10). Patients in CuTR with T2DM cohort were 1:1 propensity score matched to a non-diabetic control group for demographic factors and comorbidities, yielding 12,562 patients per group. Outcomes included 90-day postoperative medical complications and reoperation surgery at 2-years using ICD-10 and CPT codes. Patients without a minimum follow-up of 90-days and 2-years were excluded from analysis. Risk percentages, risk ratios (RR), 95% confidence intervals (CI), and
p values were calculated.
Results: Patients with T2DM experienced significantly higher rates of postoperative infections (1.5% vs. 1.2%; RR 1.315; 95% CI 1.062, 1.629;
p = 0.012), myocardial infarctions (0.9% vs. 0.6%; RR 1.432; 95% CI 1.079, 1.900;
p = 0.012), acute kidney injury (1.9% vs. 1.1%; RR 1.657; 95% CI 1.349, 2.037;
p < 0.0001), cerebral infarction (1.0% vs. 0.8%; RR 1.330; 95% CI 1.023, 1.729;
p = 0.032), reoperation at 90 days (7.3% vs. 5.8%; RR 1.270; 95% CI 1.156, 1.395;
p < 0.0001), reoperation at 2 years (14.6% vs. 11.3%; RR 1.296; 95% CI 1.203, 1.396;
p < 0.0001), and acute trigger finger at 2 years (6.3% vs. 4.3%; RR 1.478; 95% CI 1.297, 1.685;
p < 0.0001) compared to the matched non-diabetic control group.
Conclusion: A diagnosis of T2DM prior to CuTR was associated with an increased risk of postoperative infections, myocardial infarctions, acute kidney injury, cerebral infarctions, reoperation at 90-days post-surgery, reoperation at 2-years post-surgery, and acute trigger finger 2-years post-surgery compared to a matched control cohort of patients without T2DM. Understanding these correlations can help optimize preoperative support and postoperative care to improve outcomes in patients with T2DM. Further research is needed to elucidate the underlying mechanism driving these associations.
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