title: Diabetes is predictive of longer hospital stay and increased rate of complications in spinal surgery in the UK.
abstract: BACKGROUND
  Diabetes is a common co-morbidity of patients undergoing spinal surgery in the UK but there are no published studies from the UK, particularly with respect to length of hospital stay and complications. The aims of this study were to identify complications and length of hospital stay in patients with diabetes undergoing spinal surgery.
  
  
  METHODS
  Data were collected retrospectively for 111 consecutive patients with diabetes (and 97 age and sex matched control patients, identified using computer records) who underwent spinal surgery between 2004 and 2010 in a single centre. The data collected included operative time, blood loss, details of surgery, Clavien complications and length of hospital stay.
  
  
  RESULTS
  No significant differences were found by group in operative time, blood loss, instrumentation, use of graft or revision surgery. Overall complication rates were higher in the patients with diabetes than in the controls (28.8% vs 15.5%). The mean hospital stay was significantly longer for patients with diabetes than for control patients (4.6 vs 3.2 days, p<0.001).
  
  
  CONCLUSIONS
  This study identified a significantly higher Clavien grade I complication rate and length of hospital stay in patients with diabetes undergoing spinal surgery than control patients (p=0.02). This has resulted in a predictive model being generated. Of note, no infections were seen in patients with diabetes, suggesting that infection rates in this particular group of patients undergoing spinal surgery might not be as high as considered previously.
authors.affiliation: Oxford University Hospitals NHS Trust, UK. aman.sharma@ndorms.ox.ac.uk
authors.forename: A
authors.initials: A
authors.lastname: Sharma
authors.forename: R
authors.initials: R
authors.lastname: Muir
authors.forename: R
authors.initials: R
authors.lastname: Johnston
authors.forename: E
authors.initials: E
authors.lastname: Carter
authors.forename: G
authors.initials: G
authors.lastname: Bowden
authors.forename: J
authors.initials: J
authors.lastname: Wilson-MacDonald
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D016022:Case-Control Studies; D048909:Diabetes Complications / Q000150:complications*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology*; D013122:Spinal Diseases / Q000601:surgery*
chemical_list: D007004:Hypoglycemic Agents