Diabetes Mellitus in Patients Presenting with Adhesive Small Bowel Obstruction: Delaying Surgical Intervention Results in Worse Outcomes

被引:9
作者
Karamanos, Efstathios [1 ]
Dulchavsky, Scott [1 ]
Beale, Elizabeth [2 ]
Inaba, Kenji [3 ]
Demetriades, Demetrios [3 ]
机构
[1] Wayne State Univ, Dept Surg, Henry Ford Hosp, Detroit, MI USA
[2] Univ So Calif, Dept Endocrinol, Los Angeles, CA USA
[3] Univ So Calif, Div Trauma Acute Care Surg & Surg Crit Care, 2051 Marengo St, Los Angeles, CA USA
关键词
SOLUBLE CONTRAST AGENT; TRANSLOCATION; MANAGEMENT; CHOLECYSTECTOMY; METAANALYSIS; OPERATION; SURGERY; MODEL;
D O I
10.1007/s00268-015-3338-4
中图分类号
R61 [外科手术学];
学科分类号
摘要
The impact of diabetes mellitus (DM) on outcomes in patients undergoing emergency laparotomy for adhesive small bowel obstruction (ASBO) remains unknown. Low-risk (ASA class of I and II) patients requiring emergency operation for ASBO were identified using the ACS NSQIP database. Propensity score matching was used to match patients with DM to those without DM in a ratio of 1:3. Mortality, infectious complications, acute renal failure (ARF), and myocardial infarction (MI) were compared between the two groups. The impact of delaying OR a parts per thousand yen24 h was also analyzed in the two groups. A total of 1,608 patients were matched, 402 with DM and 1,204 without DM. Overall, patients with DM were significantly more likely to develop infections, ARF and MI. Diabetes had no negative impact on outcomes if the operation was performed within 24 h of admission. However, delaying surgery > 24, significantly increased infections, ARF and MI. DM in low-risk patients has no negative impact on outcomes in patients undergoing surgery for ASBO within 24 h. However, delaying surgery > 24 h resulted in worse outcomes.
引用
收藏
页码:863 / 869
页数:7
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