Effect of Diabetes on Long-term Mortality following Abdominal Aortic Aneurysm Repair: A Systemic Review and Meta-analysis

Background: The protective effect of diabetes on the prevalence and growth rate in abdominal aortic aneurysm (AAA) has been shown in several recent studies. Whether the benefits of diabetes exist in patients following AAA repair is unknown. The aim of this review is to analyze the effects of diabetes on long-term mortality following AAA repair. Methods: PubMed, Embase, and Cochrane Central Register of Controlled Trials were searched to retrieve relevant randomized controlled trials (RCTs) and observational studies which explored the influence of diabetes on long-term mortality following AAA repair. The outcome of interest was long-term mortality. A random effects model was applied to pool hazard ratio with 95% confidence interval regardless of heterogeneity. Results: A post hoc analysis of RCTs and 11 cohort studies involving 20,210 patients were included in this review. A significantly higher long-term mortality was found in diabetic patients following AAA repair (hazard ratio 1.25, 95% confidence interval 1.11-1.42, I-2=29.3%). Conclusions: The present review demonstrated that a higher long-term mortality was present in diabetic patients following AAA repair. More attention should be paid to diabetes and related complications for patients following AAA repair.