Postoperative morbidity and mortality in patients with diabetes after colorectal surgery with an enhanced recovery program: A monocentric retrospective study
[en] Background: Diabetes mellitus may increase the risk of adverse perioperative outcomes and prolong hospital stay. An enhanced recovery program (ERP) reduces surgical stress and its metabolic consequences, so attenuating the impact of preoperative risk factors. We tested the hypothesis that diabetes would have only a minor impact on outcome after colorectal surgery with an ERP. Methods: The data for patients scheduled for colorectal surgery between 2015 and 2021, were analyzed (n = 769). All the patients were managed with the same protocol. Demographic data, preoperative risk factors, postoperative complications, and length of stay were compared between patients with and without diabetes. Results: In all, 124 patients (16.1%) had diabetes, of whom 30 (24.1%) required insulin. The following preoperative risk factors for postoperative complications were significantly more frequent in the patients with diabetes: age > 70 years, ASA score ≥ III, renal failure, cardiac disease, BMI > 30 kg/m 2 , anemia, and cancer as indication for surgery. Despite more risk factors, patients with diabetes did not experience more overall postoperative complications than controls (OR (95%IC): 0.9 [0.6-1.5], p = 0.85). Length of hospital stay was not significantly longer in patients with diabetes than in those without (4 [2-7] vs. 3 [2-7] days; p = 0.45). Conclusions: Despite more risk factors, patients with diabetes did not experience more complications or longer length of stay after colorectal surgery with an ERP. The multimodal, multidisciplinary approach of ERP to reducing surgical stress may thus help mitigate the reported deleterious effects of diabetes.
Disciplines :
Anesthesia & intensive care
Author, co-author :
Lejeune, Delphine ✱; Centre Hospitalier Universitaire de Liège - CHU > > Service d'anesthésie - réanimation
Hardy, Pierre-Yves ✱; Centre Hospitalier Universitaire de Liège - CHU > > Service d'anesthésie - réanimation ; Groupe francophone de réhabilitation améliorée après chirurgie (GRACE, Francophone Group for Enhanced Recovery after Surgery), Beaumont, France
KABA, Abdourahmane ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'anesthésie - réanimation
Joris, J; Department of Anesthesiology and Reanimation, CHU Liège, University of Liège, domaine universitaire du Sart Tilman, Liège, Belgium ; Groupe francophone de réhabilitation améliorée après chirurgie (GRACE, Francophone Group for Enhanced Recovery after Surgery), Beaumont, France
✱ These authors have contributed equally to this work.
Language :
English
Title :
Postoperative morbidity and mortality in patients with diabetes after colorectal surgery with an enhanced recovery program: A monocentric retrospective study
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