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Impact of Diabetes on Postoperative Outcomes Following Colon Cancer Surgery

  • Original Research
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Abstract

Background

Diabetes is the sixth most common cause of death in the US and causes significant postoperative mortality and morbidity.

Objective

To characterize the impact of diabetes among patients undergoing surgery for colorectal cancer.

Design

This is is a retrospective cohort study.

Participants

Patients in the Nationwide Inpatient Sample (NIS) who had undergone colorectal cancer surgery between 1998 and 2005.

Measurements

Using multivariate regression, we determined the association of diabetes status with postoperative mortality, postoperative complications, and length of stay.

Key Results

An estimated 218,534 patients had undergone surgery for colorectal cancer. We categorized subjects by the presence of diabetes, the prevalence of which was 15%. Crude postoperative in-hospital mortality was lower among diabetics compared to non-diabetics (2.5% vs. 3.2%, P < 0.0001). Adjusted mortality was 23% lower in those with diabetes compared to non-diabetics (aOR 0.77; 95% CI: 0.71–0.84). Diabetics also had lower adjusted post-operative complications compared to non-diabetics (aOR 0.82; 95% CI: 0.79–0.84). In uninsured individuals and patients <50 years of age, there was no protective association between diabetes and either in-hospital mortality or postoperative complications.

Conclusions

In patients undergoing colorectal cancer surgery, those with diabetes had a 23% lower mortality and fewer postoperative complications compared to non-diabetics. The mechanisms underlying this unexpected observation warrant further investigation.

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Acknowledgements

Dr. Nguyen had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Conflict of Interest

Dr. Nguyen has served as a consultant for Schering Plough, Canada and Abbott Pharmaceutical, neither of whom had any involvement in this study. The other authors report no conflicts of interest.

Author information

Authors and Affiliations

  1. Mount Sinai Hospital Division of Gastroenterology, University of Toronto Faculty of Medicine, 600 University Ave., Ste. 433, Toronto, ON, M5G 1X5, Canada

    Nitasha Anand MD & Geoffrey C. Nguyen MD, PhD, FRCPC

  2. Queen’s University Faculty of Health Sciences, Kingston, ON, Canada

    Christopher A. Chong MD

  3. Department of Medicine, Lakeridge Health, Oshawa, ON, Canada

    Christopher A. Chong MD & Rachel Y. Chong MD, PhD

  4. Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Geoffrey C. Nguyen MD, PhD, FRCPC

Authors
  1. Nitasha Anand MD
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  2. Christopher A. Chong MD
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  3. Rachel Y. Chong MD, PhD
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  4. Geoffrey C. Nguyen MD, PhD, FRCPC
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Corresponding author

Correspondence to Geoffrey C. Nguyen MD, PhD, FRCPC.

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Anand, N., Chong, C.A., Chong, R.Y. et al. Impact of Diabetes on Postoperative Outcomes Following Colon Cancer Surgery. J GEN INTERN MED 25, 809–813 (2010). https://doi.org/10.1007/s11606-010-1336-7

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  • DOI: https://doi.org/10.1007/s11606-010-1336-7

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