Impact of Diabetes on Postoperative Outcomes Following Colon Cancer Surgery
Diabetes is the sixth most common cause of death in the US and causes significant postoperative mortality and morbidity.
To characterize the impact of diabetes among patients undergoing surgery for colorectal cancer.
This is is a retrospective cohort study.
Patients in the Nationwide Inpatient Sample (NIS) who had undergone colorectal cancer surgery between 1998 and 2005.
Using multivariate regression, we determined the association of diabetes status with postoperative mortality, postoperative complications, and length of stay.
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.
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.
KEY WORDSdiabetes nationwide colorectal cancer hyperglycemia
- 1.National Estimates of Diabetes, Center for Disease Control and Prevention. National Diabetes fact sheet:general information and national estimates on diabetes in the United States, 2005. Available at: http://apps.nccd.cdc.gov/DDTSTRS/template/ndfs_2005.pdf.
- 14.Whalen D, Houchens R, ELixhauser A. 2002 HCUP nationwide Inpatient Sample (NIS) comparison report #2005-03 ed. Rockville, MD:US. Agency for Healthcare Research and Quality 2005;1-89.Google Scholar