Impact of diabetes mellitus on head and neck cancer patients undergoing surgery

Milap D. Raikundalia, Christina H. Fang, Eleonora F. Spinazzi, Alejandro Vazquez, Richard Chan Park, Soly Baredes, Jean Anderson Eloy

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

Objective The impact of diabetes mellitus (DM) on surgical outcomes and cost of care for patients undergoing surgery for head and neck cancer (HNCA) is not well established. We used the Nationwide Inpatient Sample to analyze the postoperative impact of DM on HNCA patients. Study Design Population-based inpatient registry analysis. Setting Academic medical center. Subjects and Methods Discharge data from the Nationwide Inpatient Sample were analyzed for patients undergoing HNCA surgery from 2002 to 2010. Patient demographics, comorbidities, length of stay, hospital charges, and postoperative complications were compared between HNCA patients with and without DM. Results Of 31,075 patients, 4029 patients (13.0%) had a DM diagnosis. DM patients were older (65.7 ± 10.8 vs 61.1 ± 14.1 years old; P <.001), had more preexisting comorbidities, had longer hospitalizations, and incurred greater hospital charges. Compared with the non-DM cohort, DM patients experienced significantly higher rates of postoperative infections (2.6% vs 2.1%, P =.025), cardiac events (9.0% vs 4.3%, P <.001), pulmonary edema/failure (6.6% vs 5.7%, P =.023), acute renal failure (3.3% vs 1.5%, P <.001), and urinary tract infections (2.8 % vs 2.1%, P =.005). No differences in surgical wound healing rates were observed (0.1 vs 0.1, P =.794). On multivariate logistic regression corrected for age and race, DM patients had greater odds of postoperative infections (1.382, P =.007), cardiac events (1.893, P <.001), and acute renal failure (2.023, P <.001). Conclusions DM is associated with greater length of stay and hospital charges among HNCA patients. DM patients have significantly greater rates of postoperative complications, including postoperative infections, cardiac events, and acute renal failure.

Original languageEnglish (US)
Pages (from-to)294-299
Number of pages6
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume154
Issue number2
DOIs
StatePublished - Feb 1 2016

All Science Journal Classification (ASJC) codes

  • Surgery
  • Otorhinolaryngology

Keywords

  • Nationwide Inpatient Sample
  • complication cost
  • diabetes impact
  • diabetes mellitus
  • head and neck cancer
  • head and neck surgery
  • postoperative complications

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