Clinical impact of type 2 diabetes mellitus on outcomes after one-lung ventilation during thoracic surgery: a retrospective cohort study

Abstract

Background: The preoperative presence of diabetes mellitus (DM) has been recently demonstrated to be a risk factor for adverse events after thoracic surgery. However, the specific effects of presence of DM preoperatively on thoracic surgery is not known. This study aimed to investigate the association between preoperative DM and clinical outcomes and the short-term survival rates after thoracic surgery.Methods: In this retrospective, observational, and matched-pair analysis study, patients receiving thoracic surgery from a tertiary university hospital in 2 consecutive years were grouped as either type 2 DM (T2DM) or controlled within the first 24 hours after surgery. Multivariate Cox regression was conducted to investigate the impact of T2DM within the first 24 hours of admission on in-intensive care unit (ICU) and hospital survival.Results: Among the included thoracic patients, 41 (8.4%) had T2DM and 450 (91.6%) did not have T2DM. In the single-factor analyses, T2DM patients were shown to have a higher preoperative white blood cells (WBCs) count, increased release of immunoglobulin A, complement C3 and C4, impaired kidney function with high level of urea, and low expression of alanine aminotransferase (ALT) and monoamine oxidase (MAO). In multivariate analyses, the preoperative urea level was associated with a low-grade risk of dying for the ICU survival time. In contrast, preoperative complement C3 level favored a positive contribution in-ICU survival. Besides the complement C3 level, immunoglobulin A level remained a positive contribution in regression models of hospital survival.Conclusions: Pre-admission T2DM was not associated with an increased in-ICU and hospital mortality among patients with thoracic surgery. Furthermore, they were accompanied by impaired kidney function, activated inflammation and liver function.

Application of Different Ventilation Modes Combined with AutoFlow Technology in Thoracic Surgery

“…Under the direct vision of a high-definition television imaging system, the operation system is inserted into the chest through chest wall incision to diagnose and treat chest diseases. This operation has the advantages of small incision, small injury, and fast recovery and can be widely used in clinics [ 4 ]. Campos and Sharma believed that patients with primary bronchial lung cancer (referred to as lung cancer) and chronic obstructive pulmonary disease (COPD) had common risk factors, such as smoking, so many lung cancer patients were diagnosed with COPD in the preoperative pulmonary function assessment of thoracoscopy [ 3 ].…”

Risk of complications rise with coronary artery disease and diabetes mellitus after endobronchial valve placement in severe heterogeneous emphysema

“…Coexisting T2DM and CAD increase complication rates in many but not all studied surgical cohorts. A retrospective cohort study of patients undergoing thoracic surgery for primary tumors found no difference in postoperative complications between patients with and without T2DM 22 . However, the incidence of COPD was not reported in this trial.…”