Increased Risk of Nasal Septal Abscess After Septoplasty in Patients with Type 2 Diabetes Mellitus

Abstract

Objective/Hypothesis: To investigate the risk of nasal septal abscess (NSA) in patients with type 2 diabetes mellitus (T2DM) after septoplasty.Study Design: Retrospective cohort study through Taiwan National Health Insurance database.Methods: The Taiwan National Health Insurance Research Database was used to conduct this retrospective cohort study. A total of 382 patients with T2DM (DM group) diagnosed between 2000 and 2010 and 382 matched patients without a DM diagnosis (non-DM group) were enrolled. Patients were followed up until death or December 31, 2013. NSA incidence was the main outcome.Results: After septoplasty, the cumulative incidence of NSA in the DM group was significantly higher than that in the non-DM group (P < .001). Cox proportional hazards regression indicated a significant association between T2DM and higher NSA incidence (adjusted hazard ratio, 2.62; 95% CI, 1.44-3.61; P < .001). However, subgroup analysis and sensitivity testing demonstrated that the effect of T2DM on NSA risk was stable. In addition, the subgroup with a Diabetes Complications Severity Index (DCSI) of ≥1 had higher NSA risk than that with DCSI = 0 (adjusted hazard ratio, 3.58; 95% CI, 2.10-6.09; P < .001). The treatment type for NSA did not differ between the groups.Conclusions: T2DM is an independent risk factor for NSA in patients undergoing nasal septoplasty, and the NSA risk is greater among patients with high DM severity.

Nasal septal abscess following septoplasty in a patient with type 2 diabetes mellitus

“…6 A population-based Taiwanese study evaluated the risk of nasal septal abscess in patients with T2DM after septoplasty. 2 This study used the national health insurance database and clinical codes to identify patients, exposures and outcomes. They compared outcomes of 382 patients with T2DM versus a matched control group of 382 without diabetes mellitus following septoplasty.…”

“…A population-based Taiwanese study evaluated the risk of nasal septal abscess in patients with T2DM after septoplasty 2. This study used the national health insurance database and clinical codes to identify patients, exposures and outcomes.…”

“…Other precipitants include acute rhinosinusitis and septal surgery. 2 Prompt treatment is essential as nasal septal abscess can lead to meningitis, osteomyelitis, cerebral abscess and cavernous sinus thrombosis. 3 Furthermore, it may cause nasal septal perforation and result in significant nasal deformity.…”

“…Nasal septal abscess typically occurs in association with septal haematoma. Other precipitants include acute rhinosinusitis and septal surgery 2. Prompt treatment is essential as nasal septal abscess can lead to meningitis, osteomyelitis, cerebral abscess and cavernous sinus thrombosis 3.…”

Elevated risk of acute epiglottitis in patients with chronic obstructive pulmonary disease: A nationwide cohort study

“…Since inclusion of Haemophilus influenzae in a vaccination program for children, the incidence of epiglottitis has decreased in this demographic [8]. Modern epiglottitis has thus seemingly become an adult disease [9], and more than half of adults with epiglottis have underlying comorbidities such as cardiovascular disease, autoimmune disease, and diabetes mellitus [7,10,11].…”