https://scholars.lib.ntu.edu.tw/handle/123456789/597023
標題: | Adverse outcomes after noncardiac surgery in patientswith diabetes: A nationwide population-based retrospective cohort study | 作者: | Yeh C.-C. Liao C.-C. YI-CHENG CHANG Jeng L.-B. Yang H.-R. Shih C.-C. Chen T.-L. |
公開日期: | 2013 | 卷: | 36 | 期: | 10 | 起(迄)頁: | 3216-3221 | 來源出版物: | Diabetes Care | 摘要: | OBJECTIVE To investigate whether diabetes affects perioperative complications or mortality and to gauge its impact on medical expenditures for noncardiac surgeries. RESEARCH DESIGN AND METHODSdWith the use of reimbursement claims from the Taiwan National Health Insurance system, we performed a population-based cohort study of patients with and without diabetes undergoing noncardiac surgeries. Outcomes of postoperative complications, mortality, hospital stay, and medical expenditures were compared between patients with and without diabetes. RESULTSdDiabetes increased 30-day postoperative mortality (odds ratio 1.84 [95%CI 1.46- 2.32]), particularly among patients with type 1 diabetes or uncontrolled diabetes and patients with preoperative diabetes-related comorbidities, such as eye involvement, peripheral circulatory disorders, ketoacidosis, renal manifestations, and coma. Compared with nondiabetic control patients, coexisting medical conditions, such as renal dialysis (5.17 [3.68-7.28]), liver cirrhosis (3.59 [2.19-5.88]), stroke (2.87 [1.95-4.22]), mental disorders (2.35 [1.71-3.24]), ischemic heart disease (2.08 [1.45-2.99]), chronic obstructive pulmonary disease (1.96 [1.29- 2.97]), and hyperlipidemia (1.94 [1.01-3.76]) were associated with mortality for patients with diabetes undergoing noncardiac surgery. Patients with diabetes faced a higher risk of postoperative acute renal failure (3.59 [2.88-4.48]) and acute myocardial infarction (3.65 [2.43-5.49]). Furthermore, diabetes was associated with prolonged hospital stay (2.30 [2.16-2.44]) and increased medical expenditures (1.32 [1.25-1.40]). CONCLUSIONSdDiabetes increases postoperative 30-day mortality, complications, and medical expenditures in patients undergoing in-hospital noncardiac surgeries. ? 2013 by the American Diabetes Association. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84891846590&doi=10.2337%2fdc13-0770&partnerID=40&md5=4ab6189bdc24aec56a956bbd420dbb49 https://scholars.lib.ntu.edu.tw/handle/123456789/597023 |
ISSN: | 0149-5992 | DOI: | 10.2337/dc13-0770 | SDG/關鍵字: | acute heart infarction; acute kidney failure; adult; adverse outcome; aged; article; cerebrovascular accident; chronic obstructive lung disease; cohort analysis; coma; comorbidity; controlled study; diabetic patient; eye disease; female; health care cost; health insurance; hospitalization; human; hyperlipidemia; insulin dependent diabetes mellitus; ischemic heart disease; ketoacidosis; kidney disease; liver cirrhosis; major clinical study; male; mental disease; middle aged; noncardiac surgery; peripheral ischemia; peroperative complication; reimbursement; renal replacement therapy; retrospective study; surgery; surgical mortality; Taiwan; very elderly; young adult; Adult; Aged; Aged, 80 and over; Diabetes Mellitus; Female; Humans; Length of Stay; Logistic Models; Male; Middle Aged; Postoperative Complications; Retrospective Studies; Risk Factors; Young Adult |
顯示於: | 基因體暨蛋白體醫學研究所 |
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