title: Longer-term diabetic patients have a more frequent incidence of nosocomial infections after elective gastrectomy.
abstract: Diabetes mellitus (DM) is one of the risk factors for the development of postoperative nosocomial infections in surgical patients. We conducted this retrospective study to elucidate the perioperative risk factors for postoperative nosocomial infections in diabetic patients undergoing elective gastrectomy. Chart review was performed on diabetic and nondiabetic patients undergoing elective gastrectomy for gastric malignancy from January 1992 through April 1999. Fourteen of the 83 diabetic patients, and 23 of the 284 nondiabetic patients developed postoperative nosocomial infections. Statistical comparisons of multiple variables were made between patients with and without postoperative nosocomial infections. In diabetic patients, univariate analysis showed that longer-term DM (especially longer than 10 yr) was associated with a significantly increased risk for postoperative nosocomial infections. Multiple logistic regression analysis showed that DM lasting longer than 10 yr was an independent risk factor for postoperative nosocomial infections (odds ratio, 6.8; 95% confidence interval, 1.7 to 27.1). In nondiabetic patients, similar analysis showed that age was an independent risk factor for postoperative nosocomial infections. We conclude that patients with longer-term DM had a significantly greater incidence of postoperative nosocomial infections after elective gastrectomy.
  
  
  CONCLUSIONS
  Postoperative nosocomial infection is one of the major problems in diabetic patients. This study demonstrated that postoperative nosocomial infections were more common in patients undergoing elective gastrectomy if they had diabetes mellitus longer than 10 yr.
authors.affiliation: Departments of Anesthesia and Critical Care Medicine and Surgery, Iwaki Kyoritsu General Hospital, Uchigo, Iwaki, Fukushima, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Yamashita
authors.forename: H
authors.initials: H
authors.lastname: Yamaguchi
authors.forename: M
authors.initials: M
authors.lastname: Sakaguchi
authors.forename: T
authors.initials: T
authors.lastname: Satsumae
authors.forename: S
authors.initials: S
authors.lastname: Yamamoto
authors.forename: F
authors.initials: F
authors.lastname: Shinya
mesh_terms: D000368:Aged; D003428:Cross Infection; D048909:Diabetes Complications; D003920:Diabetes Mellitus; D017558:Elective Surgical Procedures; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000150:complications / Q000601:surgery; D013997:Time Factors