title: Splenectomy in trauma patients is associated with an increased risk of postoperative type II diabetes: a nationwide population-based study.
abstract: BACKGROUND
  Animal studies indicate that splenocytes may act as precursors of β-islet secretory cells in the pancreas. This study aimed to assess the risk of postoperative type II diabetes after splenectomy in trauma patients.
  
  
  METHODS
  We used data from the Taiwan National Health Insurance hospitalized claims. Study 1 included 3,723 patients receiving splenectomy and 3,723 matched patients receiving other types of abdominal surgery. Study 2 included 5,996 patients with spleen injury and 5,996 matched patients with other types of abdominal injury. The hazard ratio for diabetes was estimated using the matched Cox proportional hazard regression model.
  
  
  RESULTS
  In trauma patients after surgery, those who received splenectomy had a 2-fold higher risk of diabetes compared with patients without splenectomy after a 3-year follow-up period. In the nonoperative group, there was no difference in diabetes risk between patients with splenic injury and those with other types of injury.
  
  
  CONCLUSIONS
  Splenectomy was associated with an increased risk of postoperative type II diabetes in trauma patients. Thus, there may be a role for the spleen in the development of diabetes.
authors.affiliation: Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Shih-Chi
authors.initials: SC
authors.lastname: Wu
authors.affiliation: Department of Trauma and Emergency Surgery, Chang-Gung Memorial Hospital, Linkou, Taiwan.
authors.forename: Chih-Yuan
authors.initials: CY
authors.lastname: Fu
authors.affiliation: Management Office for Health Data, China Medical University and Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Chih-Hsin
authors.initials: CH
authors.lastname: Muo
authors.affiliation: Department of Health Promotion and Health Education, National Taiwan Normal University, Taipei, Taiwan. Electronic address: yjchang2012@gmail.com.
authors.forename: Yen-Jung
authors.initials: YJ
authors.lastname: Chang
mesh_terms: D000007:Abdominal Injuries / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D016016:Proportional Hazards Models; D012307:Risk Factors; D013154:Spleen / Q000293:injuries* / Q000601:surgery; D013156:Splenectomy; D016896:Treatment Outcome
keywords: Postoperative diabetes; Splenectomy; Trauma