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Postoperative adverse events in patients with diabetes undergoing orthopedic and general surgery

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机构: [a]Department of Endocrinology, Chinese PLA General Hospital, [b]Department of Endocrinology, Fifth Medical Center of PLA General Hospital, Beijing, [c]Department of Gerontology, First Affiliated Hospital of Kunming Medical University, Kunming, [d]Department of Endocrinology, Chinese PLA 307 Hospital, Beijing, China.
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关键词: diabetes mellitus perioperative care risk factors

摘要:
Factors that may result in the occurrence of adverse clinical events in diabetic patients during the postoperative period are not entirely clear. This study evaluated factors that may cause adverse events following elective orthopedic or general surgery. Patients with diabetes who underwent orthopedic or general surgery between January 2010 and October 2015 were retrospectively selected from the General Hospital of People's Liberation Army database. Factors associated with postoperative adverse events were analyzed using multivariable logistic regression. Among 1525 patients included, mean age was 63.5 +/- 10.8 years and mean duration of diabetes was 8.8 +/- 6.6 years. Among them, 49.9% underwent orthopedic surgery and 50.1% underwent general surgery. Postoperatively, 118 (7.7%) patients had adverse events, including delayed extubation (n=43, 36.4%), circulatory disorder (n=15, 12.7%), respiratory and circulatory abnormalities (n=23, 19.5%), nonhealing of the incision (n=11, 9.3%), infections at other sites (n=15, 12.7%), other complications (n=8, 6.8%), and death (n=3, 2.5%). Multivariable regression analysis showed that age > 65 years old [odds ratio (OR)=2.23, 95% confidence interval (CI): 1.25-3.98], male sex (OR=2.14, 95% CI: 1.24-3.38), postoperative peripheral blood glucose (OR=1.13, 95% CI: 1.13-1.82), diabetic complications (OR=2.41, 95% CI: 1.36-4.28), abnormal kidney function (OR=2.73, 95% CI: 1.13-6.58) and general surgery (OR=1.48, 95% CI: 1.11-5.26) were associated with the occurrence of postoperative adverse events. In patients with diabetes undergoing intermediate or major elective surgery, older age, male sex, high postoperative peripheral blood glucose, diabetic complications, abnormal kidney function, and general surgery type were associated with the occurrence of postoperative adverse events.

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出版当年[2020]版:
大类 | 4 区 医学
小类 | 4 区 医学:内科
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 医学:内科
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出版当年[2019]版:
Q3 MEDICINE, GENERAL & INTERNAL
最新[2023]版:
Q2 MEDICINE, GENERAL & INTERNAL

影响因子: 最新[2023版] 最新五年平均 出版当年[2019版] 出版当年五年平均 出版前一年[2018版] 出版后一年[2020版]

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第一作者机构: [a]Department of Endocrinology, Chinese PLA General Hospital, [b]Department of Endocrinology, Fifth Medical Center of PLA General Hospital, Beijing,
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通讯机构: [*1]Department of Endocrinology, Chinese PLA General Hospital, Beijing 100853, China
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