Oncologist Dr. Belinda Yeoh and a patient

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World-first study links diabetes to poor surgical outcomes

World-first study links diabetes to poor surgical outcomes

A world-first Austin Health study has found people with diabetes are far more likely to have adverse outcomes following surgery than those without the disease.

Diabetes was associated with significantly higher six-month mortality, major complications, intensive care unit admission and mechanical ventilation as well as increased hospital length-of-stay in the study of 7565 patients.

Published in the world's leading diabetes journal, Diabetes Care, the study measured average concentration of glucose in the blood (HbA1c level) of surgical patients (excluding day surgery) aged 54 and above admitted to Austin Health between May 2013-January 2016. Of the patients, 30 per cent were found to have diabetes.

The other major findings were:

  • Patients with diabetes had a nine per cent incidence of death within six months of surgery compared to a six per cent incidence of death in those without diabetes.
  • A major complication was present in 21 per cent of patients with diabetes compared to in 14 per cent of those without the disease.
  • 27 per cent of diabetes patients were admitted to intensive care post surgery compared to 18 per cent of those without diabetes.
  • The median cost of treating a patient with diabetes was $20,440 compared to $17,439 for those without diabetes
  • 16 per cent of diabetes patients required mechanical ventilation compared to 10 per cent of patients without diabetes.

Principal investigator and Austin Health Director of Diabetes, Associate Professor Elif Ekinci said the findings are significant and provide strong evidence that future intervention is needed.

"While we previously already knew that people with diabetes had poorer outcomes following cardiac surgery, this is the first comprehensive study worldwide showing that these patients have poorer outcomes across all surgeries," Assoc Prof Ekinci said.

"A significant finding of the current study is that poor blood sugar control before surgery, as reflected by higher HbA1c levels, is an important risk factor for major complications and intensive care unit admission."

"Diabetes currently impacts 8.8 per cent of the world's population and its prevalence is rising. Therefore, it is imperative that we understand the risk of outcomes following surgery on people with diabetes.

"Now that we have a much deeper understanding of the adverse surgical outcomes in these patients, we can investigate the interventions that we need to plan in order to prevent these outcomes".

The study was possible thanks to Austin Health's Diabetes Discovery program - an Australian-first, the initiative measures the HbA1c of every patient admitted aged 54 and above. If their HbA1c is high they are seen more quickly, or if it is suboptimal, follow-up intervention is arranged.