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Adverse Outcomes after Major Surgeries in Patients with Diabetes: A Multicenter Matched Study

The impact of diabetes on perioperative outcomes remains incompletely understood. Our purpose is to evaluate post-operative complications and mortality in patients with diabetes. Using the institutional and clinical databases of three university hospitals from 2009–2015, we conducted a matched study...

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Autores principales: Lin, Chao-Shun, Chang, Chuen-Chau, Lee, Yuan-Wen, Liu, Chih-Chung, Yeh, Chun-Chieh, Chang, Yi-Cheng, Chuang, Ming-Tsang, Chang, Tzu-Hao, Chen, Ta-Liang, Liao, Chien-Chang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352271/
https://www.ncbi.nlm.nih.gov/pubmed/30654558
http://dx.doi.org/10.3390/jcm8010100
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author Lin, Chao-Shun
Chang, Chuen-Chau
Lee, Yuan-Wen
Liu, Chih-Chung
Yeh, Chun-Chieh
Chang, Yi-Cheng
Chuang, Ming-Tsang
Chang, Tzu-Hao
Chen, Ta-Liang
Liao, Chien-Chang
author_facet Lin, Chao-Shun
Chang, Chuen-Chau
Lee, Yuan-Wen
Liu, Chih-Chung
Yeh, Chun-Chieh
Chang, Yi-Cheng
Chuang, Ming-Tsang
Chang, Tzu-Hao
Chen, Ta-Liang
Liao, Chien-Chang
author_sort Lin, Chao-Shun
collection PubMed
description The impact of diabetes on perioperative outcomes remains incompletely understood. Our purpose is to evaluate post-operative complications and mortality in patients with diabetes. Using the institutional and clinical databases of three university hospitals from 2009–2015, we conducted a matched study of 16,539 diabetes patients, aged >20 years, who underwent major surgery. Using a propensity score matching procedure, 16,539 surgical patients without diabetes who underwent surgery were also selected. Logistic regressions were used to calculate the odds ratios (ORs) with 95% confidence intervals (CIs) for post-operative complications and in-hospital mortality associated with diabetes. Patients with diabetes had a higher risk of postoperative septicemia (OR 1.33, 95% CI 1.01–1.74), necrotizing fasciitis (OR 3.98, 95% CI 1.12–14.2), cellulitis (OR 2.10, 95% CI 1.46–3.03), acute pyelonephritis (OR 1.86, 95% CI 1.01–3.41), infectious arthritis (OR 3.89, 95% CI 1.19–12.7), and in-hospital mortality (OR 1.51, 95% CI 1.07–2.13) compared to people without diabetes. Previous admission for diabetes (OR 2.33, 95% CI 1.85–2.93), HbA1c >8% (OR 1.96, 95% CI 1.64–2.33) and fasting glucose >180 mg/dL (OR 1.90, 95% CI 1.68–2.16) were predictors for post-operative adverse events. Diabetes patients who underwent surgery had higher risks of infectious complications and in-hospital mortality compared with patients without diabetes who underwent similar major surgeries.
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spelling pubmed-63522712019-02-01 Adverse Outcomes after Major Surgeries in Patients with Diabetes: A Multicenter Matched Study Lin, Chao-Shun Chang, Chuen-Chau Lee, Yuan-Wen Liu, Chih-Chung Yeh, Chun-Chieh Chang, Yi-Cheng Chuang, Ming-Tsang Chang, Tzu-Hao Chen, Ta-Liang Liao, Chien-Chang J Clin Med Article The impact of diabetes on perioperative outcomes remains incompletely understood. Our purpose is to evaluate post-operative complications and mortality in patients with diabetes. Using the institutional and clinical databases of three university hospitals from 2009–2015, we conducted a matched study of 16,539 diabetes patients, aged >20 years, who underwent major surgery. Using a propensity score matching procedure, 16,539 surgical patients without diabetes who underwent surgery were also selected. Logistic regressions were used to calculate the odds ratios (ORs) with 95% confidence intervals (CIs) for post-operative complications and in-hospital mortality associated with diabetes. Patients with diabetes had a higher risk of postoperative septicemia (OR 1.33, 95% CI 1.01–1.74), necrotizing fasciitis (OR 3.98, 95% CI 1.12–14.2), cellulitis (OR 2.10, 95% CI 1.46–3.03), acute pyelonephritis (OR 1.86, 95% CI 1.01–3.41), infectious arthritis (OR 3.89, 95% CI 1.19–12.7), and in-hospital mortality (OR 1.51, 95% CI 1.07–2.13) compared to people without diabetes. Previous admission for diabetes (OR 2.33, 95% CI 1.85–2.93), HbA1c >8% (OR 1.96, 95% CI 1.64–2.33) and fasting glucose >180 mg/dL (OR 1.90, 95% CI 1.68–2.16) were predictors for post-operative adverse events. Diabetes patients who underwent surgery had higher risks of infectious complications and in-hospital mortality compared with patients without diabetes who underwent similar major surgeries. MDPI 2019-01-16 /pmc/articles/PMC6352271/ /pubmed/30654558 http://dx.doi.org/10.3390/jcm8010100 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lin, Chao-Shun
Chang, Chuen-Chau
Lee, Yuan-Wen
Liu, Chih-Chung
Yeh, Chun-Chieh
Chang, Yi-Cheng
Chuang, Ming-Tsang
Chang, Tzu-Hao
Chen, Ta-Liang
Liao, Chien-Chang
Adverse Outcomes after Major Surgeries in Patients with Diabetes: A Multicenter Matched Study
title Adverse Outcomes after Major Surgeries in Patients with Diabetes: A Multicenter Matched Study
title_full Adverse Outcomes after Major Surgeries in Patients with Diabetes: A Multicenter Matched Study
title_fullStr Adverse Outcomes after Major Surgeries in Patients with Diabetes: A Multicenter Matched Study
title_full_unstemmed Adverse Outcomes after Major Surgeries in Patients with Diabetes: A Multicenter Matched Study
title_short Adverse Outcomes after Major Surgeries in Patients with Diabetes: A Multicenter Matched Study
title_sort adverse outcomes after major surgeries in patients with diabetes: a multicenter matched study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352271/
https://www.ncbi.nlm.nih.gov/pubmed/30654558
http://dx.doi.org/10.3390/jcm8010100
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