Postoperative Complications in Diabetic type-2 Verses Non-Diabetic Patients Undergoing Appendectomy. A Comparative clinical Study

Abstract

Background: Diabetes Mellitus (DM) is known to double the risk of postoperative complications because of weak immunity and compromised healing. Objectives: To analyse the rate of postoperative complications among diabetic and non-diabetic patients who have undergone appendectomy to determine whether the level of diabetes management has an impact on wound healing. Methodology: A prospective study was done on n=300 patients who were diagnosed with acute appendicitis and were scheduled to undergo appendectomy; of which n=150 patients had diabetes type-2 and n=150 were non- diabetics. Concerning adverse outcomes, the incidence of surgical site infections (SSIs), prolonged healing of the surgical site, and the number of days spent in the hospital after the operation were identified. Diabetes mellitus was defined based on self-reported diagnosis and glycemic control was evaluated using HbA1c level with the cut-off of >7%. Chi-square and t-tests were used in the analysis of data while multivariate logistic regression was used to assess predictors of complications. p≤0.05 was considered statistically significant. Results: Diabetic patients had a higher incidence of surgical site infections, 15.3% and 5.3%, p= 0.007 for diabetic and non-diabetic patient respectively and delayed wound healing 10.7% and 3. 3%, p = 0.015 for diabetic and non-diabetic patients respectively. Patients with HbA1c > 7% had a higher rate of SSIs of 21. 8 % and delayed healing of 15.4% compared well-controlled diabetics (p = 0.009 and p=0.02 respectively). It was more prolonged in the diabetic patients (6.1 as against 4. 3 days, p<0.001). Diabetes was found to be an independent risk factor for SSIs and slow wound healing. Conclusion: Diabetic patients who have undergone appendectomy were more susceptible to SSIs and slow healing of the wound especially if their blood glucose levels were not well controlled. It is possible that enhanced perioperative glycemic control can decrease postoperative adverse effects.