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Mortality in diabetic patients undergoing non‐cardiac surgery: a 7‐year follow‐up study
Author(s) -
KROLIKOWSKA M.,
KATAJA M.,
PÖYHIÄ R.,
DRZEWOSKI J.,
HYNYNEN M.
Publication year - 2009
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.2009.01963.x
Subject(s) - medicine , diabetes mellitus , cardiac surgery , incidence (geometry) , surgery , risk factor , endocrinology , physics , optics
Background: The prognosis of diabetic patients after non‐cardiac surgery remains controversial. This study was designed to compare the long‐term mortality between diabetic and non‐diabetic control patients undergoing non‐cardiac surgery and to evaluate the possible risk factors. Methods: We investigated 274 consecutive diabetic patients and 282 non‐diabetic control patients who underwent non‐cardiac surgery within 1 year in a tertiary care hospital in Finland. The control group was matched for the same type of operations. Patients were followed for up to 7 years on average. The main outcome measure was mortality within 7 years. Results: Mortality both in the short‐term postoperatively (≤21 days) and in the long‐term (up to 87 ½ months) was significantly higher in the diabetic patients compared with the non‐diabetic group: 3.5 vs. 0% ( P <0.05) and 37.2 vs. 15% ( P <0.00001), respectively. The major causes of death among diabetic subjects were diseases of the cardiovascular system (56.8%) compared with non‐diabetic patients (18.6%), P <0.0001. We found that diabetes mellitus per se is not a risk factor for post‐operative mortality but a combination of variables had a significant effect on both short‐ and long‐term mortality. Conclusion: Diabetic patients undergoing non‐cardiac surgery had a significantly higher incidence of short‐term post‐operative and long‐term mortality compared with non‐diabetic subjects. We propose a model of predictors of death among diabetic individuals undergoing non‐cardiac surgery within a 7‐year follow‐up. The majority of deaths were associated with cardiovascular diseases.