Diabetes Raises Risk for Postsurgical Complications
Patients with diabetes who undergo any surgery have an increased risk of experiencing complications after surgery, according to findings from a new study.
For their study, the researchers assessed 7565 surgical inpatients aged 54 years or older from May 2013 to January 2016. Patient data were obtained from hospital records. Follow-up lasted 6 months.
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Diabetes was defined as either preexisting diabetes or a hemoglobin A1c (HbA1c) of at least 6.5%. Prediabetes was diagnosed in patients with an HbA1c between 5.7% and 6.4%, and patients with an HbA1c of less than 5.7% were considered normoglycemic.
The present analysis was performed using random-effects logistic and negative binomial regression models, with surgical units treated as random effects. A 6-month mortality risk model was constructed via classification and regression tree (CART) analysis.
Ultimately, 30% and 37% of surgical inpatients in this cohort had diabetes and prediabetes, respectively.
Following adjustment for various factors, results of the study indicated that diabetes was tied to higher risks of 6-month mortality (adjusted odds ratio [aOR] 1.29). This risk among patients with diabetes and other risk factors was confirmed via CART analysis.
Furthermore, findings showed that the presence of diabetes was also associated with major complications (aOR 1.32), admission to the intensive care unit (ICU; aOR 1.50), and hospital length of stay (LOS; adjusted incidence rate ratio [aIRR] 1.08).
The risks for major complications (aOR 1.07), ICU admission (aOR 1.14), and longer hospital LOS (aIRR 1.05) increased with each percentage increase in HbA1c.
“Diabetes and higher HbA1c were independently associated with a higher risk of adverse outcomes after surgery,” the researchers concluded.
—Christina Vogt
Reference:
Yong PH, Weinberg L, Torkamani N, et al. The presence of diabetes and higher HbA1c are independently associated with adverse outcomes after surgery. Diabetes Care. 2018;41(6):1172-1179. https://doi.org/10.2337/dc17-2304