Efstathios Karamanos1, Scott Dulchavsky1, Elizabeth Beale2, Kenji Inaba3, Demetrios Demetriades4. 1. Department of Surgery, Henry Ford Hospital/Wayne State University, Detroit, MI, USA. 2. Department of Endocrinology, University of Southern California, Los Angeles, CA, USA. 3. Division of Trauma, Acute Care Surgery and Surgical Critical Care, University of Southern California, 2051 Marengo Street, Los Angeles, CA, USA. 4. Division of Trauma, Acute Care Surgery and Surgical Critical Care, University of Southern California, 2051 Marengo Street, Los Angeles, CA, USA. demetria@usc.edu.
Abstract
INTRODUCTION: The impact of diabetes mellitus (DM) on outcomes in patients undergoing emergency laparotomy for adhesive small bowel obstruction (ASBO) remains unknown. METHODS: Low-risk (ASA class of I and II) patients requiring emergency operation for ASBO were identified using the ACS NSQIP database. Propensity score matching was used to match patients with DM to those without DM in a ratio of 1:3. Mortality, infectious complications, acute renal failure (ARF), and myocardial infarction (MI) were compared between the two groups. The impact of delaying OR ≥ 24 h was also analyzed in the two groups. RESULTS: A total of 1,608 patients were matched, 402 with DM and 1,204 without DM. Overall, patients with DM were significantly more likely to develop infections, ARF and MI. Diabetes had no negative impact on outcomes if the operation was performed within 24 h of admission. However, delaying surgery >24, significantly increased infections, ARF and MI. CONCLUSIONS: DM in low-risk patients has no negative impact on outcomes in patients undergoing surgery for ASBO within 24 h. However, delaying surgery >24 h resulted in worse outcomes.
INTRODUCTION: The impact of diabetes mellitus (DM) on outcomes in patients undergoing emergency laparotomy for adhesive small bowel obstruction (ASBO) remains unknown. METHODS: Low-risk (ASA class of I and II) patients requiring emergency operation for ASBO were identified using the ACS NSQIP database. Propensity score matching was used to match patients with DM to those without DM in a ratio of 1:3. Mortality, infectious complications, acute renal failure (ARF), and myocardial infarction (MI) were compared between the two groups. The impact of delaying OR ≥ 24 h was also analyzed in the two groups. RESULTS: A total of 1,608 patients were matched, 402 with DM and 1,204 without DM. Overall, patients with DM were significantly more likely to develop infections, ARF and MI. Diabetes had no negative impact on outcomes if the operation was performed within 24 h of admission. However, delaying surgery >24, significantly increased infections, ARF and MI. CONCLUSIONS:DM in low-risk patients has no negative impact on outcomes in patients undergoing surgery for ASBO within 24 h. However, delaying surgery >24 h resulted in worse outcomes.
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