[Results of carotid endarterectomy in diabetic patients].
Patients with diabetes mellitus have been shown to have an increased incidence of complications after major vascular surgery. The objective of this study was to evaluate the results of carotid endarterectomy in diabetic patients, to determine if results differ from nondiabetic patients, and to examine the risk factors for poor outcome among diabetic patients.


METHODS
We reviewed all carotid endarterectomies performed in Emergency Hospital of Vilnius University. From 1995 to 2005, 707 carotid endarterectomies were performed. Of these, 100 operations were performed in diabetic patients (14%) and the remaining 607 in nondiabetic patients.


RESULTS
Diabetic patients were younger (P<0.05) and were obese more often (P<0.001), they smoked less often (P<0.001) than nondiabetic patients. Diabetics were more likely to have severe bilateral carotid stenosis than nondiabetic patients (P<0.01). Postoperative complications (stroke) were more common in diabetic patients than in nondiabetic patients (12.0% vs. 3.4%, P<0.001) as well as intracerebral hemorrhages (3.0% vs. 0.3%, P<0.001); no perioperative myocardial infarction was found in diabetic patients. Risk factors for complications were age >/=75 (odds ratio (OR) 2.2; 95% confidence interval (CI)=1.0-4.9), smoking (OR 2.7; 95% CI=1.8-4.2), obesity (OR 6.1; 95% CI=3.9-9.5), and bilateral carotid stenosis (OR 2.1; 95% CI=1.3-3.6).


CONCLUSIONS
Diabetes mellitus significantly increased the risk of mortality and intracerebral hemorrhage but not myocardial infarction. It should be taken into consideration in making decisions about the performance and perioperative management of carotid endarterectomy.
Meskauskiene
Aukse
A
Clinic of Neurology and Neurosurgery, Vilnius University, Siltnamiu 29, 04130 Vilnius, Lithuania. auksemeskauskiene@hotmail.com
Barkauskas
Egidijus
E
Gaigalaite
Virginija
V
D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D016893:Carotid Stenosis / Q000601:surgery*; D002543:Cerebral Hemorrhage / Q000209:etiology; D016001:Confidence Intervals; D003627:Data Interpretation, Statistical; D003925:Diabetic Angiopathies / Q000601:surgery*; D016894:Endarterectomy, Carotid / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D009765:Obesity / Q000150:complications; D016017:Odds Ratio; D011183:Postoperative Complications; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D020521:Stroke / Q000209:etiology; D016896:Treatment Outcome