THE INFLUENCE OF DIABETES-MELLITUS ON THE RISK OF ABDOMINAL AORTIC-SURGERY

Risk factors and postoperative complications of 153 diabetics (DM) who underwent an abdominal aortic operation for occlusive disease or an i ntact aneurysm from 1964 through June, 1988 were compared with 970 non diabetics (nonDM) who underwent similar operations during the same tim e period. Heart disease, hypertension, cerebrovascular disease, and re nal insufficiency were more prevalent in diabetics. Postoperatively, D M had a statistically significant increase in the incidence of myocard ial infarction (DM 5.2%, nonDM 2.1%, P = .0434) and wound infection (D M 2.6%, nonDM 0.6%, P = .0359). The incidence of renal failure (DM 1.3 %, nonDM 1.0%), stroke (DM 2.0%, nonDM 0.6%), and death (DM 3.9%, nonD M 2.9%) was higher in diabetics, but the differences were not statisti cally significant (P = NS). Operative mortality was greater for patien ts operated on for aneurysm (DM 5.3%, nonDM 3.2%) than for patients op erated for occlusive disease (DM 3.3% versus nonDM 2.7%). Diabetics tr eated with insulin or oral agents had a higher complication rate than diabetics treated with diet alone or nondiabetics (insulin 13.0%, oral 13.4%, diet 4.2%, nonDM 8.6%). This study finds that diabetic patient s can undergo an abdominal aortic operation with operative mortality c omparable to that of nondiabetics. Diabetics have more postoperative c omplications than nondiabetics, but only myocardial infarction and wou nd infection are of statistical significance. Diabetics treated with i nsulin or oral agents have more complications than do diabetics treate d by diet alone or nondiabetics.