Diabetes mellitus as a risk factor for surgical site infection in colorectal surgery. Does preoperative and postoperative glycemic control matter?

Mejia, Julie; Sadurní, M.; Vilà, Esther; Zalbidea, Maite; Cantillo, Jordi; Escolano, F.

doi:10.1097/00003643-201406001-00588

Cited by 2 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, this study points out that the long-term control of diabetes to reduce the incidence and severity of these associated pre-morbid conditions is probably more important than the short-term control of perioperative hyper- and hypo- glycaemia. Although outcomes such as wound infection have had direct association with hyper- and hypo- glycaemia [8–10], this area is not well studied. This adds another argument to effective long-term control of diabetes; that is, the improvement of perioperative outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…There is also speculation that hyperglycemia in itself may be an underlying factor leading to poorer outcomes [5]. The function of leukocytes has shown to be adversely affected under hyperglycemic conditions [6, 7], and numerous studies have shown that diabetes is a factor for increased risk in surgical wound infections [8–10]. This effect on poor wound healing is probably through inhibition of various mechanisms, such as inhibition of keratinocyte migration, reduced fibroblast proliferation and over-expression of c-myc [11–13].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Effect of Diabetes on the Perioperative Outcomes of Colorectal Cancer Surgery Patients

et al. 2016

View full text Add to dashboard Cite

There are approximately 1.3 million patients in Australia with diabetes. Conflicting reports exist in the literature as to the effect of diabetes on the outcomes of colorectal cancer patients. We hypothesized that patients with diabetes would have poorer perioperative outcomes, and that diabetes was an independent risk factor for both 30-day mortality and perioperative morbidity. The aim of this study was to assess the impact of diabetes on perioperative colorectal cancer surgery outcomes, as compared to a diabetes-free reference population, and to examine factors affecting perioperative risk. We conducted an analysis of a prospectively collected, clinician-led colorectal cancer database of patients from 2010–2015. Patients with diabetes were compared to patients without diabetes on a range of perioperative outcomes. Pearson χ-squared tests, Wilcoxon rank sum tests and t-tests were employed for univariate analyses. Confounding factors were controlled for by separate logistic and linear regression analyses. The Huber-White Sandwich Estimator was used to calculate robust standard errors. A total of 1725 patients were analysed over 1745 treatment episodes in the study period with 267 patients (268 episodes) with diabetes studied. Diabetes contributed to medical, surgical complications, and increased length of inpatient stay in univariate analyses. Multivariable analysis adjusted for variables independently associated with each outcome revealed that diabetes was an independent contributor to an increased risk of surgical complications, with no significant effect on medical complications, return to the operating room, 30-day mortality, or readmission within 30 days. In this study, where overall baseline morbidity and mortality levels are low, the effect of diabetes alone on perioperative surgical outcomes appears to be overstated with control of associated perioperative risk factors such as cardiac, renal and respiratory factors being more important.

show abstract

Section: Discussionmentioning

confidence: 99%