About this Journal Submit a Manuscript Table of Contents
ISRN Surgery
Volume 2013 (2013), Article ID 963930, 9 pages
http://dx.doi.org/10.1155/2013/963930
Research Article

Outcomes of Diabetic and Nondiabetic Patients Undergoing General and Vascular Surgery

1Department of Surgery, Covenant Healthcare, Central Michigan University College of Medicine, Saginaw, MI 48603, USA
2Department of Research, Covenant Healthcare, Central Michigan University College of Medicine, Saginaw, MI 48603, USA
3Department of Quality, Covenant Healthcare, Saginaw, MI 48603, USA

Received 13 June 2013; Accepted 19 August 2013

Academic Editors: A. Polydorou and M. J. Underwood

Copyright © 2013 Stephen Serio et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aims. Preoperative diabetic and glycemic screening may or may not be cost effective. Although hyperglycemia is known to compromise surgical outcomes, the effect of a diabetic diagnosis on outcomes is poorly known. We examine the effect of diabetes on outcomes for general and vascular surgery patients. Methods. Data were collected from the Michigan Surgical Quality Collaborative for general or vascular surgery patients who had diabetes. Primary and secondary outcomes were 30-day mortality and 30-day overall morbidity, respectively. Binary logistic regression analysis was used to identify risk factors. Results. We identified 177,430 (89.9%) general surgery and 34,006 (16.1%) vascular surgery patients. Insulin and noninsulin diabetics accounted for 7.1% and 9.8%, respectively. Insulin and noninsulin dependent diabetics were not at increased risk for mortality. Diabetics are at a slight increased odds than non-diabetics for overall morbidity, and insulin dependent diabetics more so than non-insulin dependent. Ventilator dependence, 10% weight loss, emergent case, and ASA class were most predictive. Conclusions. Diabetics were not at increased risk for postoperative mortality. Insulin-dependent diabetics undergoing general or vascular surgery were at increased risk of overall 30-day morbidity. These data provide insight towards mitigating poor surgical outcomes in diabetic patients and the cost effectiveness of preoperative diabetic screening.