title: Diabetes mellitus is not associated with major morbidity following open abdominal aortic aneurysm repair.
abstract: BACKGROUND
  It has been suggested that there is an increased morbidity and mortality risk for diabetics undergoing elective aortic surgery. This, however, is not universally accepted. In this study, we utilize a national database to determine if diabetes is associated with adverse outcomes following open, elective, infrarenal abdominal aortic aneurysm (AAA) repair.
  
  
  METHODS
  The American College of Surgeons' National Surgical Quality Improvement Program database was queried to identify all patients who underwent an open, elective, nonruptured AAA repair from January 1, 2005 to December 31, 2007. Patient demographics, comorbidities, and outcomes were compared by diabetes status. Multivariate analysis was performed adjusting for demographics and comorbidities.
  
  
  RESULTS
  There were 2110 American College of Surgeons' National Surgical Quality Improvement Program patients who underwent an open, elective, nonruptured AAA repair during this time period. Of these patients, 245 (11.6%) had diabetes mellitus. The overall mortality rate was 3.7% (5.3% for diabetics and 3.5% for nondiabetics, P = 0.171). On bivariate analysis, diabetics were more likely to present preoperatively with cardiovascular and renal comorbidities. Postoperatively, there was no significant difference in mortality or in cardiac, pulmonary, or renal complications. Diabetics were more likely to develop superficial surgical site infections (SSIs) (4.5% versus 1.6%, P = 0.002). On multivariate regression, there was no difference in mortality or major complications between diabetics and nondiabetics (OR 1.4, 95% CI 0.68-2.71). Diabetics, however, were almost three times more likely to develop superficial SSIs (OR 2.8, 95% CI 1.29-6.00).
  
  
  CONCLUSIONS
  Diabetes mellitus is not associated with significantly worse major outcomes following open, elective, infrarenal AAA repair. Diabetics, however, are more likely to develop superficial SSIs.
authors.affiliation: Department of Surgery, Howard University College of Medicine, Washington, District of Columbia. Electronic address: kakra.hughes@howard.edu.
authors.forename: Kakra
authors.initials: K
authors.lastname: Hughes
authors.forename: Jade D
authors.initials: JD
authors.lastname: Jackson
authors.forename: Tahira I
authors.initials: TI
authors.lastname: Prendergast
authors.forename: David A
authors.initials: DA
authors.lastname: Rose
authors.forename: Oluwaseyi
authors.initials: O
authors.lastname: Bolorunduro
authors.forename: Augustine
authors.initials: A
authors.lastname: Obirieze
authors.forename: Edward E
authors.initials: EE
authors.lastname: Cornwell
authors.forename: Wendy R
authors.initials: WR
authors.lastname: Greene
authors.forename: Thomas
authors.initials: T
authors.lastname: Obisesan
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000401:mortality* / Q000601:surgery*; D048909:Diabetes Complications / Q000150:complications*; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Abdominal aortic aneurysm; Diabetes mellitus