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.

No abstract

Over the past decade, drinking and driving has been a major social problem causing deaths and injuries. The present study examined factors that may encourage this potentially self‐destructive behavior. Three hundred and seventy‐eight subjects were presented with scenarios describing a night of drinking with friends. Scenarios differed with respect to three levels of intoxication (not at all, slight, and very) and two levels of weather (clear and rain). Subjects were asked to estimate the proportion of their peers who would drive home or choose an alternative form of transportation. Subjects were also asked to evaluate the target who drove home or took an alternative in terms of likability, cautiousness, skillfulness and independence. Driving home was found to be the most common mode of transportation, regardless of state of drunkenness or weather conditions. Alternatives to driving home were seen as being utilized only under extreme conditions (e.g., very intoxicated and rainy weather). Moreover, persons taking one of the more cautious alternatives were perceived as overly cautious and also low in skillfulness. The practical implications for the findings are discussed with respect to enhancing education efforts.