Effect of diabetes mellitus on perioperative conditions of patients undergoing hepatectomy

doi:10.3877/cma.j.issn.2095-3232.2021.01.018

Abstract

Abstract:

Objective

To evaluate the effect of diabetes mellitus on the perioperative conditions of patients undergoing hepatectomy.

Methods

Clinical data of 4 003 patients who underwent hepatectomy in West China Hospital from January 2015 to March 2020 were retrospectively analyzed. Among them, 2 557 patients were male and 1 446 female, aged from 22 to 79 years with a median age of 59 years. The informed consents of all patients were obtained and the local ethical committee approval was received. With the propensity score matching (PSM) method, all patients were allocated into the diabetes mellitus and non-diabetes mellitus groups with a ratio of 1:4. The effect of diabetes mellitus on perioperative conditions after hepatectomy was evaluated. The preoperative preparation time and length of postoperative hospital stay was compared by using t test. The incidence of complications was compared by Chi-square test or Fisher's exact probability test.

Results

After PSM, 188 diabetes mellitus patients and 685 non-diabetes mellitus patients were included in this study. In the diabetes mellitus group, the preoperative preparation time and length of postoperative hospital stay were (5.1±4.2) d and (9.5±5.6) d, significantly longer than (4.2±2.7) d and (8.4±5.0) d in the non-diabetes mellitus group (t=3.77, 2.59; P<0.05). In the diabetes mellitus group, the overall incidence of postoperative complications was 11.7%(22/188), significantly higher than 6.9%(47/685)in the non-diabetes mellitus group (χ2=4.749, P<0.05).

Conclusions

In patients with diabetes mellitus, the incidence of perioperative complications is significantly increased and the length of hospital stay is prolonged. Preoperative evaluation and perioperative management should be strengthened.

Key words: Diabetes mellitus, Hepatectomy, Perioperative care, Postoperative complications, Length of hospital stay

Chuang Jiang, Mingheng Liao, Yong Zeng. Effect of diabetes mellitus on perioperative conditions of patients undergoing hepatectomy[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2021, 10(01): 82-86.

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References 26

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指标		PSM前（n=4 003）				PSM后（n=873）
指标		非糖尿病组（n=3 807）	糖尿病组（n=196）	统计值	P值	非糖尿病组（n=685）	糖尿病组（n=188）	统计值	P值
男性（例）		2 412	145	χ²=9.116	0.003	502	139	χ²=0.032	0.858
年龄（岁，±s）		49±13	60±9	t=-11.66	<0.001	59±10	60±9	t=-1.51	0.131
基础疾病（例）				χ²=26.070	<0.001			χ²=0.609	0.962
	良性肿瘤	645	13			48	13
	肝细胞癌	1 963	124			443	119
	感染性疾病	610	18			58	16
	其他恶性肿瘤	425	29			102	28
	肝转移性肿瘤	164	12			34	12
切除肝段数量（例）				-	0.856			-	0.917
	1	1 237	68			207	63
	2	985	51			179	49
	3	729	36			138	36
	4	714	37			143	36
	5	133	4			18	4
	6	9	0			0	0
肝硬化（例）				χ²=1.965	0.161			χ²=0.132	0.716
	否	2 422	115			387	109
	是	1 385	81			298	79

指标		PSM前（n=4 003）				PSM后（n=873）
指标		非糖尿病组（n=3 807）	糖尿病组（n=196）	统计值	P值	非糖尿病组（n=685）	糖尿病组（n=188）	统计值	P值
男性（例）		2 412	145	χ²=9.116	0.003	502	139	χ²=0.032	0.858
年龄（岁，±s）		49±13	60±9	t=-11.66	<0.001	59±10	60±9	t=-1.51	0.131
基础疾病（例）				χ²=26.070	<0.001			χ²=0.609	0.962
	良性肿瘤	645	13			48	13
	肝细胞癌	1 963	124			443	119
	感染性疾病	610	18			58	16
	其他恶性肿瘤	425	29			102	28
	肝转移性肿瘤	164	12			34	12
切除肝段数量（例）				-	0.856			-	0.917
	1	1 237	68			207	63
	2	985	51			179	49
	3	729	36			138	36
	4	714	37			143	36
	5	133	4			18	4
	6	9	0			0	0
肝硬化（例）				χ²=1.965	0.161			χ²=0.132	0.716
	否	2 422	115			387	109
	是	1 385	81			298	79

组别	例数	术前准备时间（d，±s）	术后住院时间（d，±s）	总住院时间（d，±s）	并发症（例）
组别	例数	术前准备时间（d，±s）	术后住院时间（d，±s）	总住院时间（d，±s）	Ⅱ级	Ⅲ级及以上
糖尿病组	188	5.1±4.2	9.5±5.6	14.6±7.5	16	6
非糖尿病组	685	4.2±2.7	8.4±5.0	12.6±5.8	36	11
统计值		t=3.77	t=2.59	t=4.03	χ²=4.749
P值		<0.001	0.010	<0.001	0.020

组别	例数	术前准备时间（d，±s）	术后住院时间（d，±s）	总住院时间（d，±s）	并发症（例）
组别	例数	术前准备时间（d，±s）	术后住院时间（d，±s）	总住院时间（d，±s）	Ⅱ级	Ⅲ级及以上
糖尿病组	188	5.1±4.2	9.5±5.6	14.6±7.5	16	6
非糖尿病组	685	4.2±2.7	8.4±5.0	12.6±5.8	36	11
统计值		t=3.77	t=2.59	t=4.03	χ²=4.749
P值		<0.001	0.010	<0.001	0.020

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