Filimonov Andrey, Chung Sei Yeon, Wong Anni, Brady Jacob S, Baredes Soly, Eloy Jean Anderson
Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ.
Center for Skull Base and Pituitary Surgery, Neurological Institute of New Jersey, Rutgers New Jersey Medical School, Newark, NJ.
Int Forum Allergy Rhinol. 2017 Jun;7(6):584-590. doi: 10.1002/alr.21906. Epub 2017 Mar 10.
Endoscopic sinus surgery (ESS) has become the treatment of choice for a variety of nasal conditions. The purpose of this study was to analyze the effect of diabetes mellitus (DM) on postoperative outcomes in ESS.
Data on endoscopic sinus surgery performed from 2005 to 2013 were collected from the American College of Surgeons National Surgical Quality Improvement (ACS-NSQIP) database. Two groups were created, based on the presence of a DM diagnosis, and were analyzed for preoperative variables, comorbidities, and postoperative complications using SPSS statistical software.
There were 644 patients included in the analysis, 85 of whom (13.2%) had a diagnosis of DM. Patients with DM were more likely to have higher rates of preoperative dyspnea and hypertension. After accounting for confounding factors, DM patients undergoing ESS were at higher risk of overall medical complications, pneumonia, unplanned reintubation, ventilator use of >48 hours, and mortality. However, after separating patients into outpatient and inpatient groups, DM was found to be an independent predictor of urinary tract infection in outpatients and of ventilator use >48 hours in inpatients.
DM patients undergoing ESS are at increased risk for postoperative medical complications. However, DM does not appear to increase the postoperative surgical complication rate in this population. Furthermore, DM does not appear to have an impact on ESS mortality, readmission, or reoperation rates.
内镜鼻窦手术（ESS）已成为多种鼻腔疾病的首选治疗方法。本研究的目的是分析糖尿病（DM）对ESS术后结果的影响。
从美国外科医师学会国家外科质量改进（ACS-NSQIP）数据库中收集2005年至2013年进行的内镜鼻窦手术数据。根据是否存在DM诊断创建两组，并使用SPSS统计软件分析术前变量、合并症和术后并发症。
分析纳入644例患者，其中85例（13.2%）诊断为DM。DM患者术前呼吸困难和高血压发生率更高。在考虑混杂因素后，接受ESS的DM患者发生总体医疗并发症、肺炎、意外再次插管、呼吸机使用超过48小时和死亡的风险更高。然而，将患者分为门诊和住院组后，发现DM是门诊患者尿路感染和住院患者呼吸机使用超过48小时的独立预测因素。
接受ESS的DM患者术后发生医疗并发症的风险增加。然而，DM似乎并未增加该人群的术后手术并发症发生率。此外，DM似乎对ESS死亡率、再入院率或再次手术率没有影响。
