title: Preexisting Diabetes and Risks of Morbidity and Mortality After Gastrectomy for Gastric Cancer: A Nationwide Database Study.
abstract: The purpose of this study was to determine the risk of surgical mortality and morbidity in patients with diabetes mellitus (DM) undergoing a gastrectomy for gastric cancer (GC). Using the Taiwan National Health Insurance Research Database, we identified 6284 patients who underwent gastrectomy for GC from 1999 to 2010. In addition, we created a non-DM control cohort consisting of 6268 patients who received gastrectomy during the same period. Compared with the non-DM cohort, the DM cohort exhibited a higher prevalence of preoperative coexisting medical conditions, namely hypertension, hyperlipidemia, coronary artery disease, chronic kidney disease, chronic pulmonary disease, stroke, and cirrhosis. The odds ratio (OR) of 30-day postoperative mortality after gastrectomy in the DM cohort was 1.04 (95% confidence interval 0.78-1.40) after we adjusted for covariates. The DM cohort did not exhibit a significantly higher risk of 30-day postoperative morbidities. Further analysis revealed that only patients with a history of a DM-related coma exhibited a higher risk of 30-day postoperative mortality (adjusted OR 2.46, 95% confidence interval 1.10 - 5.54). Moreover, the risk of 90-day postoperative mortality was significantly higher in patients with DM-related eye involvement, coma, peripheral circulatory disease, and renal manifestations, in comparison with the non-DM cohort. The risk of 90-day mortality after gastrectomy for GC is higher in patients with DM-related manifestations than those without DM.
authors.affiliation: From the Department of Surgery (M-ST), E-Da Hospital and I-Shou University, Kaohsiung; Management Office for Health Data; College of Medicine (Y-CW), China Medical University, Taichung; Department of Medical Research (Y-HK), E-Da Hospital and I-Shou University, Kaohsiung; Department of Surgery (L-BJ), Organ Transplantation Center, China Medical University Hospital; Graduate Institute of Clinical Medical Science and School of Medicine (L-BJ, C-HK), College of Medicine, China Medical University; and Department of Nuclear Medicine and PET Center (C-HK), China Medical University Hospital, Taichung, Taiwan.
authors.forename: Ming-Shian
authors.initials: MS
authors.lastname: Tsai
authors.forename: Yu-Chiao
authors.initials: YC
authors.lastname: Wang
authors.forename: Yin-Hsien
authors.initials: YH
authors.lastname: Kao
authors.forename: Long-Bin
authors.initials: LB
authors.lastname: Jeng
authors.forename: Chia-Hung
authors.initials: CH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000368:Aged; D048909:Diabetes Complications / Q000401:mortality* / Q000601:surgery; D005260:Female; D005743:Gastrectomy / Q000401:mortality*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000150:complications / Q000401:mortality* / Q000601:surgery; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult