Impact of diabetes on postoperative outcomes following colon cancer surgery.
BACKGROUND
Diabetes is the sixth most common cause of death in the US and causes significant postoperative mortality and morbidity.


OBJECTIVE
To characterize the impact of diabetes among patients undergoing surgery for colorectal cancer.


METHODS
This is is a retrospective cohort study.


METHODS
Patients in the Nationwide Inpatient Sample (NIS) who had undergone colorectal cancer surgery between 1998 and 2005.


METHODS
Using multivariate regression, we determined the association of diabetes status with postoperative mortality, postoperative complications, and length of stay.


RESULTS
An estimated 218,534 patients had undergone surgery for colorectal cancer. We categorized subjects by the presence of diabetes, the prevalence of which was 15%. Crude postoperative in-hospital mortality was lower among diabetics compared to non-diabetics (2.5% vs. 3.2%, P < 0.0001). Adjusted mortality was 23% lower in those with diabetes compared to non-diabetics (aOR 0.77; 95% CI: 0.71-0.84). Diabetics also had lower adjusted post-operative complications compared to non-diabetics (aOR 0.82; 95% CI: 0.79-0.84). In uninsured individuals and patients <50 years of age, there was no protective association between diabetes and either in-hospital mortality or postoperative complications.


CONCLUSIONS
In patients undergoing colorectal cancer surgery, those with diabetes had a 23% lower mortality and fewer postoperative complications compared to non-diabetics. The mechanisms underlying this unexpected observation warrant further investigation.
Anand
Nitasha
N
Mount Sinai Hospital Division of Gastroenterology, University of Toronto Faculty of Medicine, 600 University Ave., Ste. 433, Toronto, ON, M5G 1X5, Canada.
Chong
Christopher A
CA
Chong
Rachel Y
RY
Nguyen
Geoffrey C
GC
D000368:Aged; D003106:Colon / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000401:mortality / Q000601:surgery*; D016001:Confidence Intervals; D003920:Diabetes Mellitus / Q000401:mortality*; D005260:Female; D006304:Health Status; D017052:Hospital Mortality; D006801:Humans; D006943:Hyperglycemia; D007902:Length of Stay / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States