The neglected perioperative population of undiagnosed diabetics – a retrospective cohort study
| Autor: | Weiling Liu, Lydia Q. Liew, Vanessa Chua, Edwin Seet, Jiexun Wang, Wei W. Teo, Lian Kah Ti, Lyn Li Lean, Ambika Paramasivan |
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| Rok vydání: | 2020 |
| Předmět: |
Blood Glucose
Male medicine.medical_specialty Population lcsh:Surgery 030230 surgery Logistic regression Undiagnosed Diseases 03 medical and health sciences Diabetes mellitus 0302 clinical medicine Risk Factors Internal medicine Prevalence medicine Humans Mortality General surgery Perioperative Period education Aged Retrospective Studies Singapore education.field_of_study Univariate analysis Asian business.industry Atrial fibrillation Retrospective cohort study lcsh:RD1-811 General Medicine Odds ratio Perioperative Middle Aged medicine.disease Surgery Diabetes Mellitus Type 2 Surgical Procedures Operative 030220 oncology & carcinogenesis Female Morbidity business Research Article |
| Zdroj: | BMC Surgery BMC Surgery, Vol 20, Iss 1, Pp 1-7 (2020) |
| ISSN: | 1471-2482 |
| DOI: | 10.1186/s12893-020-00844-2 |
| Popis: | Background Diabetes is known to increase morbidity and 30-day mortality in adults undergoing non-cardiac surgery, but longer term outcomes are less studied. This study was done to explore how undiagnosed and known diabetes affect 30-day and one-year morbidity and mortality outcomes. The secondary aim was to study the prevalence of undiagnosed diabetics in our perioperative Asian surgical population. Methods A retrospective cohort study of 2106 patients aged > 45 years undergoing non-cardiac surgery in a single tertiary hospital was performed. Undiagnosed diabetics were identified (HbA1c ≥6.5% or fasting blood glucose ≥126 mg/dL) and relevant demographic, clinical and surgical data were analyzed to elicit the relationship to adverse outcomes. Univariate analysis was first performed to identify significant variables with p-values ≤0.1, which were then analyzed using multiple logistic regression to calculate the adjusted odds ratio. Results The prevalence of undiagnosed diabetes was 7.4%. The mean and median HbA1c of known diabetics were 7.9 and 7.5%, while the mean and median HbA1c for undiagnosed diabetics were 7.2 and 6.8% respectively. 36.4% of known diabetics and 20.5% of undiagnosed diabetics respectively had a random blood glucose > 200 mg/dL. Undiagnosed diabetics had a three-fold increase in 1-year mortality compared to non-diabetics (adjusted OR 3.46(1.80–6.49) p p = 0.047), infection (aOR 1.49(1.07–2.07) p = 0.017), 30-day readmission (aOR 1.62(1.17–2.25) p = 0.004) and 30-day mortality (aOR 3.11(1.16–8.56) p = 0.025). Conclusions Although undiagnosed diabetics have biochemically less severe disease compared to known diabetics at the point of testing, they are at a one-year mortality disadvantage which is not seen among known diabetics. This worrying trend highlights the importance of identifying and treating diabetes. Congruent to previous studies, known diabetics have higher morbidity and 30-day mortality compared to non-diabetics. |
| Databáze: | OpenAIRE |
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