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The Effect of Diabetes on the Perioperative Outcomes of Colorectal Cancer Surgery Patients

There are approximately 1.3 million patients in Australia with diabetes. Conflicting reports exist in the literature as to the effect of diabetes on the outcomes of colorectal cancer patients. We hypothesized that patients with diabetes would have poorer perioperative outcomes, and that diabetes was...

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Autores principales: Yap, Raymond, Wilkins, Simon, Staples, Margaret, Oliva, Karen, McMurrick, Paul J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5132159/
https://www.ncbi.nlm.nih.gov/pubmed/27907053
http://dx.doi.org/10.1371/journal.pone.0167271
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author Yap, Raymond
Wilkins, Simon
Staples, Margaret
Oliva, Karen
McMurrick, Paul J.
author_facet Yap, Raymond
Wilkins, Simon
Staples, Margaret
Oliva, Karen
McMurrick, Paul J.
author_sort Yap, Raymond
collection PubMed
description There are approximately 1.3 million patients in Australia with diabetes. Conflicting reports exist in the literature as to the effect of diabetes on the outcomes of colorectal cancer patients. We hypothesized that patients with diabetes would have poorer perioperative outcomes, and that diabetes was an independent risk factor for both 30-day mortality and perioperative morbidity. The aim of this study was to assess the impact of diabetes on perioperative colorectal cancer surgery outcomes, as compared to a diabetes-free reference population, and to examine factors affecting perioperative risk. We conducted an analysis of a prospectively collected, clinician-led colorectal cancer database of patients from 2010–2015. Patients with diabetes were compared to patients without diabetes on a range of perioperative outcomes. Pearson χ-squared tests, Wilcoxon rank sum tests and t-tests were employed for univariate analyses. Confounding factors were controlled for by separate logistic and linear regression analyses. The Huber-White Sandwich Estimator was used to calculate robust standard errors. A total of 1725 patients were analysed over 1745 treatment episodes in the study period with 267 patients (268 episodes) with diabetes studied. Diabetes contributed to medical, surgical complications, and increased length of inpatient stay in univariate analyses. Multivariable analysis adjusted for variables independently associated with each outcome revealed that diabetes was an independent contributor to an increased risk of surgical complications, with no significant effect on medical complications, return to the operating room, 30-day mortality, or readmission within 30 days. In this study, where overall baseline morbidity and mortality levels are low, the effect of diabetes alone on perioperative surgical outcomes appears to be overstated with control of associated perioperative risk factors such as cardiac, renal and respiratory factors being more important.
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spelling pubmed-51321592016-12-21 The Effect of Diabetes on the Perioperative Outcomes of Colorectal Cancer Surgery Patients Yap, Raymond Wilkins, Simon Staples, Margaret Oliva, Karen McMurrick, Paul J. PLoS One Research Article There are approximately 1.3 million patients in Australia with diabetes. Conflicting reports exist in the literature as to the effect of diabetes on the outcomes of colorectal cancer patients. We hypothesized that patients with diabetes would have poorer perioperative outcomes, and that diabetes was an independent risk factor for both 30-day mortality and perioperative morbidity. The aim of this study was to assess the impact of diabetes on perioperative colorectal cancer surgery outcomes, as compared to a diabetes-free reference population, and to examine factors affecting perioperative risk. We conducted an analysis of a prospectively collected, clinician-led colorectal cancer database of patients from 2010–2015. Patients with diabetes were compared to patients without diabetes on a range of perioperative outcomes. Pearson χ-squared tests, Wilcoxon rank sum tests and t-tests were employed for univariate analyses. Confounding factors were controlled for by separate logistic and linear regression analyses. The Huber-White Sandwich Estimator was used to calculate robust standard errors. A total of 1725 patients were analysed over 1745 treatment episodes in the study period with 267 patients (268 episodes) with diabetes studied. Diabetes contributed to medical, surgical complications, and increased length of inpatient stay in univariate analyses. Multivariable analysis adjusted for variables independently associated with each outcome revealed that diabetes was an independent contributor to an increased risk of surgical complications, with no significant effect on medical complications, return to the operating room, 30-day mortality, or readmission within 30 days. In this study, where overall baseline morbidity and mortality levels are low, the effect of diabetes alone on perioperative surgical outcomes appears to be overstated with control of associated perioperative risk factors such as cardiac, renal and respiratory factors being more important. Public Library of Science 2016-12-01 /pmc/articles/PMC5132159/ /pubmed/27907053 http://dx.doi.org/10.1371/journal.pone.0167271 Text en © 2016 Yap et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Yap, Raymond
Wilkins, Simon
Staples, Margaret
Oliva, Karen
McMurrick, Paul J.
The Effect of Diabetes on the Perioperative Outcomes of Colorectal Cancer Surgery Patients
title The Effect of Diabetes on the Perioperative Outcomes of Colorectal Cancer Surgery Patients
title_full The Effect of Diabetes on the Perioperative Outcomes of Colorectal Cancer Surgery Patients
title_fullStr The Effect of Diabetes on the Perioperative Outcomes of Colorectal Cancer Surgery Patients
title_full_unstemmed The Effect of Diabetes on the Perioperative Outcomes of Colorectal Cancer Surgery Patients
title_short The Effect of Diabetes on the Perioperative Outcomes of Colorectal Cancer Surgery Patients
title_sort effect of diabetes on the perioperative outcomes of colorectal cancer surgery patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5132159/
https://www.ncbi.nlm.nih.gov/pubmed/27907053
http://dx.doi.org/10.1371/journal.pone.0167271
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