接受关节镜下肩袖修复术的 II 型糖尿病患者使用塞马鲁肽可降低术后并发症和肩袖再撕裂的风险。

Anthony E Seddio, Jay Moran, Michael J Gouzoulis, Nickolas G Garbis, Dane H Salazar, Jonathan N Grauer, Andrew E Jimenez
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引用次数: 0

摘要

目的:研究 II 型糖尿病(T2DM)患者在接受关节镜下肩袖修复术(ARCR)后,术前使用塞马鲁肽(Ozempic® 和 Wegovy® 的活性剂)对术后九十天疗效和两年肩袖再撕裂的潜在影响:方法:使用管理账单代码从PearlDiver数据库中确定接受初级ARCR的T2DM患者。排除标准包括:患者:匹配后,符合纳入标准的 ARCR (+)semaglutide 患者有 1,094 人,ARCR (-)semaglutide 患者有 4,110 人。ARCR (-)semaglutide 和 ARCR (+)semaglutide 患者的 AAE 发生率分别为 27.4% 和 11.0%,SAE 发生率分别为 10.5% 和 3.5%,MAE 发生率分别为 22.0% 和 8.5%(p 结论:ARCR (-)semaglutide 和 ARCR (+)semaglutide 患者的 AAE 发生率分别为 27.4% 和 11.0%,SAE 发生率分别为 10.5% 和 3.5%,MAE 发生率分别为 22.0% 和 8.5%:接受ARCR的T2DM患者术前使用semaglutide与90天轻微和严重不良事件发生率降低以及2年肩袖再撕裂率降低有关:证据级别:III级,回顾性比较研究。
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Lower Risk of Postoperative Complications and Rotator Cuff Retear Associated with Semaglutide Use in Patients with Type II Diabetes Mellitus Undergoing Arthroscopic Rotator Cuff Repair.

Purpose: To investigate the potential impact of preoperative semaglutide use (active agent in Ozempic® and Wegovy®) on ninety-day postoperative outcomes and two-year rotator cuff retear following arthroscopic rotator cuff repair (ARCR) for type II diabetes mellitus (T2DM) patients.

Methods: T2DM patients undergoing primary ARCR were identified from the PearlDiver database using administrative billing codes. Exclusion criteria included: patients <18 years old, prior RCR, concurrent non-rotator cuff related arthroscopic shoulder procedures, any traumatic, neoplastic, or infectious diagnoses within 90-days before surgery, and <90-days follow-up. T2DM patients using semaglutide within one-year of ARCR ([+]semaglutide) were matched 1:4 with T2DM patients who did not ([-]semaglutide) by age, sex, Elixhauser Comorbidity Index (ECI), diabetes complications, obesity, tobacco, insulin, and metformin use. Occurrence of any, severe, and minor adverse events (AAE, SAEs, MAEs, respectively) within 90-days were compared by multivariable logistic regression. Two-year retear was assessed by Kaplan-Meier survival analysis and compared by log-rank test.

Results: There were 1,094 ARCR (+)semaglutide and 4,110 ARCR (-)semaglutide patients meeting inclusion criteria after matching. The incidence of AAE for the ARCR (-)semaglutide vs. ARCR (+)semaglutide patients was 27.4% vs. 11.0%, SAE was 10.5% vs. 3.5%, and MAE was 22.0% vs. 8.5%, respectively (p<0.001 for all). ARCR (-)semaglutide patients had a higher odds ratio (OR) of AAE (3.65, p<0.001) and SAEs (3.62, p<0.001), including surgical-site infection (2.22, p=0.049), venous thromboembolism (3.10, p<0.001), sepsis (3.87, p<0.001), and cardiac events (3.96, p<0.001). Also, greater odds of MAEs (3.59, p<0.001), including urinary tract infection (3.27), pneumonia (3.88), acute kidney injury (3.91), and ED visits (2.51) (p<0.001 for all). Additionally, (-)semaglutide patients revealed higher 2-year retear vs (+)semaglutide patients (18.3% vs 12.5%, respectively) (p<0.001).

Conclusion: Preoperative semaglutide use for T2DM patients undergoing ARCR was associated with decreased odds of minor and serious 90-day adverse events, and lower 2-year rotator cuff retear.

Level of evidence: Level III, retrospective comparative study.

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来源期刊
CiteScore
9.30
自引率
17.00%
发文量
555
审稿时长
58 days
期刊介绍: Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.
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