An article published in Spine examines how diabetes impacts spine surgery outcomes.
Researchers analyzed the Nationwide Inpatient Sample form 2002 to 2011 and examined patients who underwent lumbar spine surgery for degenerative conditions. The study included 403,629 controlled diabetic patients and 19,421 uncontrolled diabetic patients. The researchers found:
1. Patients with uncontrolled diabetes had significantly higher odds of complications than the patients with controlled diabetes, including:
• Cardiac complications
• Deep venous thrombosis
• Postoperative shock
2. The uncontrolled diabetic patients also had increased average length of stay at the hospital when compared with other patients. The patients with uncontrolled diabetes stayed for approximately 2.5 days longer than patients with controlled diabetes.
3. There were greater costs associated with patients who had uncontrolled diabetes. Patients with uncontrolled diabetes had 1.3-fold higher costs than patients with controlled diabetes.
4. The patients with controlled diabetes had a lower risk of inpatient mortality than patients with uncontrolled diabetes.
5. When compared with patients who didn't have diabetes, patients with controlled diabetes had higher acute complication risk and inpatient mortality. However, they were still at lower risk than patients with uncontrolled diabetes.
"Patients with uncontrolled diabetes mellitus, or poor glucose control, may benefit from improving glycemic control prior to surgery," concluded the study authors.