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World Journal of Surgery

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01-04-2016 | Original Scientific Report

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

Authors: Efstathios Karamanos, Scott Dulchavsky, Elizabeth Beale, Kenji Inaba, Demetrios Demetriades

Published in: World Journal of Surgery | Issue 4/2016

Abstract

Introduction

The impact of diabetes mellitus (DM) on outcomes in patients undergoing emergency laparotomy for adhesive small bowel obstruction (ASBO) remains unknown.

Methods

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 ≥24 h was also analyzed in the two groups.

Results

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.

Conclusions

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.

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Title: Diabetes Mellitus in Patients Presenting with Adhesive Small Bowel Obstruction: Delaying Surgical Intervention Results in Worse Outcomes
Authors: Efstathios Karamanos
Scott Dulchavsky
Elizabeth Beale
Kenji Inaba
Demetrios Demetriades
Publication date: 01-04-2016
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 4/2016
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-015-3338-4

At a glance: The STEP trials

Springer Medicine

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

Abstract

Introduction

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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