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Post-surgery Complications More Likely with Insulin-dependent Diabetes

Insulin-dependent diabetes patients were at an increased risk of post-surgery complications following lumbar fusion including death, sepsis, wound infection and 30-day readmission….

Patients with insulin-dependent diabetes mellitus (IDDM) have an increased risk of a number of postoperative complications after lumbar fusion compared with those who have noninsulin-dependent diabetes mellitus (NIDDM) or no diabetes.
Nicholas S. Golinvaux, from Yale University in New Haven, Connecticut, and colleagues retrospectively analyzed data from the American College of Surgeons National Surgical Quality Improvement Program database and identified 15,480 patients who underwent lumbar fusion between 2005 and 2012. Patients were characterized as having NIDDM (1,650), IDDM (787), or neither (13,043).
The researchers found that NIDDM was independently associated with an increased risk of wound dehiscence (relative risk [RR], 2.3) and extended length of stay (RR, 1.2). There were independent associations between IDDM and increased risk of death (RR, 2.7), sepsis (RR, 2.2), septic shock (RR, 3.3), unplanned intubation (RR, 2.8), ventilator-assisted respiration for more than 48 hours postoperatively (RR, 2.8), wound-related infection (RR, 1.9), urinary tract infection (RR, 1.6), pneumonia (RR, 3.1), extended length of stay (RR, 1.5), and readmission within 30 days (RR, 1.5).
“This important designation may improve preoperative risk stratification and counseling of patients with diabetes prior to lumbar fusion surgery,” conclude the authors.
Spine, Oct 1, 2014