Defining the Association between Diabetes and Plastic Surgery Outcomes: An Analysis of Nearly 40,000 Patients
Background:. Diabetes is an increasingly prevalent comorbidity in patients presenting for surgery, impacting nearly 14% of adults in the United States. Although it is known that diabetic patients are at an increased risk for postoperative complications, there is a paucity of literature on the specif...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2017-08-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000001461 |
| _version_ | 1818522261875851264 |
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| author | David Goltsman, MBBS Kerry A. Morrison, MD Jeffrey A. Ascherman, MD |
| author_facet | David Goltsman, MBBS Kerry A. Morrison, MD Jeffrey A. Ascherman, MD |
| author_sort | David Goltsman, MBBS |
| collection | DOAJ |
| description | Background:. Diabetes is an increasingly prevalent comorbidity in patients presenting for surgery, impacting nearly 14% of adults in the United States. Although it is known that diabetic patients are at an increased risk for postoperative complications, there is a paucity of literature on the specific ramifications of diabetes on different surgical procedures.
Methods:. Using the American College of Surgeons National Surgical Quality Improvement Program dataset, demographics, outcomes, and length of in-patient hospitalization were examined for patients who underwent plastic surgery between 2007 and 2012. Adjusted multivariable logistic regression models were used to assess the relationship between diabetes status and a spectrum of medical and surgical postoperative outcomes.
Results:. Thirty-nine thousand four hundred seventy-five plastic surgery patients were identified, including 1,222 (3.10%) with insulin-dependent diabetes mellitus (IDDM) and 1,915 (4.75%) with non–insulin-dependent diabetes mellitus (NIDDM), who had undergone breast, hand/upper and lower extremity, abdominal, or craniofacial procedures. Logistic regression analyses showed that only insulin-dependent diabetics had a higher likelihood of surgical complications (IDDM: P value < 0.0001; NIDDM: P value < 0.103), whereas patients with both IDDM and NIDDM had increased likelihoods of medical complications (IDDM: P value < 0.001; NIDDM: P value = 0.0093) compared with nondiabetics. Average hospital stay for diabetics was also longer than for nondiabetics.
Conclusions:. Diabetes is associated with an increase in a multitude of postoperative complications and in hospital length of stay, in patients undergoing plastic surgery. Diabetes status should thus be evaluated and addressed when counseling patients preoperatively. Risks may be further stratified based on IDDM versus NIDDM status. |
| first_indexed | 2024-12-11T05:30:56Z |
| format | Article |
| id | doaj.art-ed43746f2731489a92b9e5bd89e00f2b |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-11T05:30:56Z |
| publishDate | 2017-08-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-ed43746f2731489a92b9e5bd89e00f2b2022-12-22T01:19:26ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742017-08-0158e146110.1097/GOX.0000000000001461201708000-00012Defining the Association between Diabetes and Plastic Surgery Outcomes: An Analysis of Nearly 40,000 PatientsDavid Goltsman, MBBS0Kerry A. Morrison, MD1Jeffrey A. Ascherman, MD2From the *Division of Plastic Surgery, Department of Surgery, Columbia University College of Physicians and Surgeons, Columbia University Medical Center, New York Presbyterian Hospital, New York, N.Y.; and †Department of Plastic Surgery, Prince of Wales Hospital, Sydney, New South Wales, Australia.From the *Division of Plastic Surgery, Department of Surgery, Columbia University College of Physicians and Surgeons, Columbia University Medical Center, New York Presbyterian Hospital, New York, N.Y.; and †Department of Plastic Surgery, Prince of Wales Hospital, Sydney, New South Wales, Australia.From the *Division of Plastic Surgery, Department of Surgery, Columbia University College of Physicians and Surgeons, Columbia University Medical Center, New York Presbyterian Hospital, New York, N.Y.; and †Department of Plastic Surgery, Prince of Wales Hospital, Sydney, New South Wales, Australia.Background:. Diabetes is an increasingly prevalent comorbidity in patients presenting for surgery, impacting nearly 14% of adults in the United States. Although it is known that diabetic patients are at an increased risk for postoperative complications, there is a paucity of literature on the specific ramifications of diabetes on different surgical procedures. Methods:. Using the American College of Surgeons National Surgical Quality Improvement Program dataset, demographics, outcomes, and length of in-patient hospitalization were examined for patients who underwent plastic surgery between 2007 and 2012. Adjusted multivariable logistic regression models were used to assess the relationship between diabetes status and a spectrum of medical and surgical postoperative outcomes. Results:. Thirty-nine thousand four hundred seventy-five plastic surgery patients were identified, including 1,222 (3.10%) with insulin-dependent diabetes mellitus (IDDM) and 1,915 (4.75%) with non–insulin-dependent diabetes mellitus (NIDDM), who had undergone breast, hand/upper and lower extremity, abdominal, or craniofacial procedures. Logistic regression analyses showed that only insulin-dependent diabetics had a higher likelihood of surgical complications (IDDM: P value < 0.0001; NIDDM: P value < 0.103), whereas patients with both IDDM and NIDDM had increased likelihoods of medical complications (IDDM: P value < 0.001; NIDDM: P value = 0.0093) compared with nondiabetics. Average hospital stay for diabetics was also longer than for nondiabetics. Conclusions:. Diabetes is associated with an increase in a multitude of postoperative complications and in hospital length of stay, in patients undergoing plastic surgery. Diabetes status should thus be evaluated and addressed when counseling patients preoperatively. Risks may be further stratified based on IDDM versus NIDDM status.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000001461 |
| spellingShingle | David Goltsman, MBBS Kerry A. Morrison, MD Jeffrey A. Ascherman, MD Defining the Association between Diabetes and Plastic Surgery Outcomes: An Analysis of Nearly 40,000 Patients Plastic and Reconstructive Surgery, Global Open |
| title | Defining the Association between Diabetes and Plastic Surgery Outcomes: An Analysis of Nearly 40,000 Patients |
| title_full | Defining the Association between Diabetes and Plastic Surgery Outcomes: An Analysis of Nearly 40,000 Patients |
| title_fullStr | Defining the Association between Diabetes and Plastic Surgery Outcomes: An Analysis of Nearly 40,000 Patients |
| title_full_unstemmed | Defining the Association between Diabetes and Plastic Surgery Outcomes: An Analysis of Nearly 40,000 Patients |
| title_short | Defining the Association between Diabetes and Plastic Surgery Outcomes: An Analysis of Nearly 40,000 Patients |
| title_sort | defining the association between diabetes and plastic surgery outcomes an analysis of nearly 40 000 patients |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000001461 |
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