BACKGROUND: Diabetes mellitus (DM) is associated with adverse events or complications in various gastrointestinal diseases. In this study, we examined whether diabetic patients had higher risk for the development of complicated acute appendicitis than nondiabetic patients. The relevant risk factors also were determined. METHODS: A retrospective study enrolling diabetic and nondiabetic patients who acquired acute appendicitis was conducted at a single institution over a 5-year period. RESULTS: We identified 1,184 patients with a primary discharge diagnosis of acute appendicitis. Seventy-one patients were found to have DM. Diabetic patients were older, had a higher risk of developing complicated acute appendicitis (CAA), and had a more prolonged hospital stay compared with nondiabetic patients. On further examination by multivariate logistic regression analysis, DM was an independent risk factor for CAA after adjusting for age and sex. Of the 71 diabetic patients, 46 patients (64.8%) were found to have CAA. The mean age of diabetic patients with uncomplicated acute appendicitis (DM/UAA) and CAA (DM/CAA) had no significant difference. The duration from the onset of symptoms to diagnosis was significantly longer in the DM/CAA than in the DM/UAA group. The mean length of hospital stay also was significantly longer in the DM/CAA than in the DM/UAA group. DM/CAA patients were found to have a higher rate of history of diabetic nephropathy as well as a higher serum creatinine level and a lower estimated glomerular filtration rate than DM/UAA patients. There was no statistical significance regarding patients older or younger than 60 years. CONCLUSIONS: Our study showed that diabetic patients had a higher risk for the development of CAA and a subsequently longer hospital stay than nondiabetic patients. Age was not an independent risk factor for the development of CAA in diabetic patients in our study. Delayed diagnosis, and probably a history of diabetic nephropathy, as well as poorer renal function were risk factors for the development of CAA in diabetic patients. The single most important risk factor was the duration from the onset of symptoms to diagnosis. Once CAA developed, the length of hospital stay was prolonged significantly.
BACKGROUND:Diabetes mellitus (DM) is associated with adverse events or complications in various gastrointestinal diseases. In this study, we examined whether diabeticpatients had higher risk for the development of complicated acute appendicitis than nondiabeticpatients. The relevant risk factors also were determined. METHODS: A retrospective study enrolling diabetic and nondiabeticpatients who acquired acute appendicitis was conducted at a single institution over a 5-year period. RESULTS: We identified 1,184 patients with a primary discharge diagnosis of acute appendicitis. Seventy-one patients were found to have DM. Diabeticpatients were older, had a higher risk of developing complicated acute appendicitis (CAA), and had a more prolonged hospital stay compared with nondiabeticpatients. On further examination by multivariate logistic regression analysis, DM was an independent risk factor for CAA after adjusting for age and sex. Of the 71 diabeticpatients, 46 patients (64.8%) were found to have CAA. The mean age of diabeticpatients with uncomplicated acute appendicitis (DM/UAA) and CAA (DM/CAA) had no significant difference. The duration from the onset of symptoms to diagnosis was significantly longer in the DM/CAA than in the DM/UAA group. The mean length of hospital stay also was significantly longer in the DM/CAA than in the DM/UAA group. DM/CAApatients were found to have a higher rate of history of diabetic nephropathy as well as a higher serum creatinine level and a lower estimated glomerular filtration rate than DM/UAApatients. There was no statistical significance regarding patients older or younger than 60 years. CONCLUSIONS: Our study showed that diabeticpatients had a higher risk for the development of CAA and a subsequently longer hospital stay than nondiabeticpatients. Age was not an independent risk factor for the development of CAA in diabeticpatients in our study. Delayed diagnosis, and probably a history of diabetic nephropathy, as well as poorer renal function were risk factors for the development of CAA in diabeticpatients. The single most important risk factor was the duration from the onset of symptoms to diagnosis. Once CAA developed, the length of hospital stay was prolonged significantly.
Authors: Maciej Walędziak; Anna Lasek; Michał Wysocki; Michael Su; Maciej Bobowicz; Piotr Myśliwiec; Kamil Astapczyk; Mateusz Burdzel; Karolina Chruściel; Rafał Cygan; Wojciech Czubek; Natalia Dowgiałło-Wnukiewicz; Jakub Droś; Paula Franczak; Wacław Hołówko; Artur Kacprzyk; Wojciech Konrad Karcz; Jakub Kenig; Paweł Konrad; Arkadiusz Kopiejć; Adam Kot; Karolina Krakowska; Maciej Kukla; Agnieszka Leszko; Leszek Łozowski; Piotr Major; Wojciech Makarewicz; Paulina Malinowska-Torbicz; Maciej Matyja; Maciej Michalik; Adam Niekurzak; Damian Nowiński; Radomir Ostaszewski; Małgorzata Pabis; Małgorzata Polańska-Płachta; Mateusz Rubinkiewicz; Tomasz Stefura; Anna Stępień; Paweł Szabat; Rafał Śmiechowski; Sebastian Tomaszewski; Viktor von Ehrlich-Treuenstätt; Maciej Wasilczuk; Mateusz Wierdak; Anna Wojdyła; Jan Wojciech Wroński; Leszek Zwolakiewicz; Michał Pędziwiatr Journal: Sci Rep Date: 2019-10-15 Impact factor: 4.379