Send to

Choose Destination
J Arthroplasty. 2015 Jul;30(7):1197-202. doi: 10.1016/j.arth.2015.01.040. Epub 2015 Jan 31.

Is Hemoglobin A1c or Perioperative Hyperglycemia Predictive of Periprosthetic Joint Infection or Death Following Primary Total Joint Arthroplasty?

Author information

University of Utah, Department of Orthopaedics, Salt Lake City, Utah.
University of Utah, Pharmacotherapy Outcomes Research Center, College of Pharmacotherapy, Salt Lake City, Utah; IDEAS 2.0, Veterans Affairs Salt Lake City Health System, Salt Lake City, Utah.
University of Utah, Department of Medicine, Salt Lake City, Utah.


We sought to determine if HbA1c and perioperative hyperglycemia were positively associated with the incidence of PJI. We retrospectively reviewed the VA VINCI database on patients who underwent primary joint arthroplasty between 2001 and 2011 and had HbA1c and perioperative blood glucose levels. Of 13,272 patients, 38% (n=5035) had an elevated perioperative HbA1c ≥7%. While there was no increased risk of infection associated with elevated HbA1c (HR 0.86, P=0.23), mortality was increased (HR 1.3, P=0.01). Preoperative hyperglycemia was associated with an increased incidence of PJI (HR 1.44, P=0.008). While HbA1c did not perfectly correlate with the risk of PJI, perioperative hyperglycemia did, and may be a target for optimization to decrease the burden of PJI.


diabetes mellitus; hemoglobin A1c; perioperative glucose; periprosthetic joint infection; total joint arthroplasty

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center