Introduction: Previous studies have noted an association between diabetes and increased risk of surgical complications. The aim of this study was to analyze whether non-insulin dependent diabetes mellitus (NIDDM) and insulin dependent diabetes mellitus (IDDM) influence complication rates in patients undergoing adult deformity surgery (ADS).
Methods: Adult patients (>18 years) undergoing ADS from 2005-2012 were categorized into groups of nondiabetic, IDDM, and NIDDM. Baseline, operative, and outcomes data were compared. Univariate and multivariate analyses were performed to assess the effects of IDDM and NIDDM on 30-day postoperative complications and mortality.
Results: 4,716 patients underwent ADS during the study period; of those, 431 had NIDDM (10.4%) and 198 had IDDM (4.2%). On multivariate analysis assessing 30-day outcomes, the patients in the NIDDM group had a statistically significant increased risk of urinary tract infection (3.71% compared to 1.59% in nondiabetics, OR 1.926, 95% CI 1.094-3.392, p=0.02) and cardiac arrest (0.70% versus 0.14% in nondiabetics, OR 4.85, 95% CI 1.209-19.46, p=0.03). Patients with IDDM did not have increased risks compared to patients without diabetes.
Conclusions: Patients with NIDDM have increased complication rates following ADS, specifically with urinary tract infection and cardiac arrest. Patients with IDDM did not have increased postoperative complication rates.
Patient Care: These data will assist providers with a better understanding of what drives the variations in patient care.
Learning Objectives: To assess the effects of NIDDM and IDDM of 30 day complication rates after ADS.