Session Title: Annual Assembly Late Breaking Posters (Non Presentations)
Session Time: 11:15am-12:45pm
Location: Research Hub - Kiosk 8
Disclosures: Kristyn Williams: No financial relationships or conflicts of interest
Objective: This study aimed to determine the percentage of patients undergoing musculoskeletal corticosteroid injections (MSK CSI) with a known diagnosis of diabetes (DM) and to retrospectively assess for adverse diabetes-related healthcare events requiring acute intervention within 1 week following MSK CSI.
Design: Retrospective chart review.
Setting: Outpatient clinics at a large community hospital in Dallas, TX.
Participants: 7,886 encounters of patients receiving at least one MSK CSI from 1/1/16 to 4/30/19.
Interventions: Not applicable.
Main Outcome Measures: 1) Percentage of patients receiving site-specific MSK CSI with DM 2) Number and description of unplanned diabetic healthcare encounters requiring acute intervention within 1 week of receiving MSK CSI at any site, and separated by axial and appendicular injections sites.
Results: A total of 2,428 of 7,886 (30.8%) CSI were administered to patients with DM, including 461 of 1,835 (25.1%) axial and 1,967 of 6,051 (32.5%) appendicular injections. On average, patients receiving axial injections, as compared to appendicular injections, were younger (58.5 +/-9.7 and 62.5 +/-10.0, respectively) and had a lower baseline hemoglobin A1c (HbA1c) level (6.9 +/-1.1 and 7.1 +/-1.4, respectively). A total of 29 injections resulted in an unexpected diabetic encounter requiring an intervention including 1 hospital admission, 3 ER visits, and 25 outpatient visits and/or phone calls. 3 injections required more than 1 healthcare utilization. All diabetic encounters were related to hyperglycemia or change in glucose control following the injection. The overall adverse event rate was 1.19%, with rates of 0.65% and 1.32% for injections following axial and appendicular sites, respectively.
Conclusions: This is the first report to assess the clinical consequence of altered glucose levels following MSK CSI showing 1.19% of injections requiring acute diabetic intervention in the week following injection. Adverse event rates were higher following appendicular versus axial injections, though baseline differences and low event rates limit between group comparisons. Further research is needed.
Level of Evidence: Level IV
To cite this abstract in AMA style:Williams K, Ramey L. A Retrospective Study Evaluating Risks Associated with Musculoskeletal Corticosteroid Injections in Patients with Diabetes [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/a-retrospective-study-evaluating-risks-associated-with-musculoskeletal-corticosteroid-injections-in-patients-with-diabetes/. Accessed September 28, 2023.
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