Increased Risk of Nasal Septal Abscess After Septoplasty in Patients with Type 2 Diabetes Mellitus

Objective/Hypothesis To investigate the risk of nasal septal abscess (NSA) in patients with type 2 diabetes mellitus (T2DM) after septoplasty. Study Design Retrospective cohort study through Taiwan National Health Insurance database. Methods The Taiwan National Health Insurance Research Database was used to conduct this retrospective cohort study. A total of 382 patients with T2DM (DM group) diagnosed between 2000 and 2010 and 382 matched patients without a DM diagnosis (non-DM group) were enrolled. Patients were followed up until death or December 31, 2013. NSA incidence was the main outcome. Results After septoplasty, the cumulative incidence of NSA in the DM group was significantly higher than that in the non-DM group (P < .001). Cox proportional hazards regression indicated a significant association between T2DM and higher NSA incidence (adjusted hazard ratio, 2.62; 95% CI, 1.44-3.61; P < .001). However, subgroup analysis and sensitivity testing demonstrated that the effect of T2DM on NSA risk was stable. In addition, the subgroup with a Diabetes Complications Severity Index (DCSI) of >= 1 had higher NSA risk than that with DCSI = 0 (adjusted hazard ratio, 3.58; 95% CI, 2.10-6.09; P < .001). The treatment type for NSA did not differ between the groups. Conclusions T2DM is an independent risk factor for NSA in patients undergoing nasal septoplasty, and the NSA risk is greater among patients with high DM severity. Level of Evidence IV Laryngoscope, 2020