Zeng Yuhuan, Lei Yuanhu, Li Min, Liu Wei, Zhou Jie, Zhong Jie, Song Guangming, Li Yukun, Tan Xiangfang, Zhang Qunfeng
The Second Affiliated Hospital, Hengyang Medical School, University of South China, Hengyang City, Hunan Province, China.
The Second Affiliated Hospital, Blood transfusion department, Hengyang Medical School, University of South China, Hengyang, 421000, Hunan, China.
BMC Womens Health. 2025 Jun 7;25(1):284. doi: 10.1186/s12905-025-03835-8.
Although diabetes mellitus (DM) is considered an important prognostic factor for hysterectomy outcomes, the relationship between DM and postoperative complications remains unclear. The aim of this study was to investigate whether DM is associated with an increased risk of complications following hysterectomy.
We systematically searched PubMed, Embase, and the Cochrane Library for relevant articles published on or before March 15, 2024. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated via random effects meta-analysis. The primary outcome was the risk of complications posthysterectomy, including postoperative infection and hospital readmission. Additionally, we conducted subgroup and sensitivity analyses to explore the main sources of heterogeneity and assess the stability of the results.
A total of 19 cohort studies comprising 375,531 participants met the inclusion criteria. This meta-analysis revealed that DM was significantly associated with postoperative infection (OR 2.01, 95% CI 1.46-2.77). Additionally, DM was significantly associated with low postoperative survival (5 years) (OR 4.43, 95% CI 2.98-6.58), readmission (OR 1.59, 95% CI 1.42-1.79), embolism (OR 1.31, 95% CI 1.18-1.46), renal failure (OR 3.88, 95% CI 2.74-5.51) and reintubation (OR 3.23, 95% CI 1.64-6.35), whereas DM was not associated with an extended length of stay (OR 1.39, 95% CI 0.93-2.10), myocardial infarction (OR 1.86, 95% CI 0.58-5.98) or blood transfusion (OR 1.36, 95% CI 0.88-2.11) in patients following hysterectomy.
DM increases the risk of postoperative infection following hysterectomy. Special attention should be given to diabetic patients to reduce the incidence of complications after hysterectomy.
尽管糖尿病（DM）被认为是子宫切除术后预后的一个重要因素，但DM与术后并发症之间的关系仍不明确。本研究的目的是调查DM是否与子宫切除术后并发症风险增加相关。
我们系统检索了PubMed、Embase和Cochrane图书馆，查找2024年3月15日或之前发表的相关文章。通过随机效应荟萃分析计算合并比值比（OR）和95%置信区间（CI）。主要结局是子宫切除术后的并发症风险，包括术后感染和再次入院。此外，我们进行了亚组分析和敏感性分析，以探讨异质性的主要来源并评估结果的稳定性。
共有19项队列研究，包括375,531名参与者符合纳入标准。这项荟萃分析表明，DM与术后感染显著相关（OR 2.01，95% CI 1.46 - 2.77）。此外，DM与术后低生存率（5年）（OR 4.43，95% CI 2.98 - 6.58）、再次入院（OR 1.59，95% CI 1.42 - 1.79）、栓塞（OR 1.31，95% CI 1.18 - 1.46）、肾衰竭（OR 3.88，95% CI 2.74 - 5.51）和再次插管（OR 3.23，95% CI 1.64 - 6.35）显著相关，而DM与子宫切除术后患者的住院时间延长（OR 1.39，95% CI 0.93 - 2.10）、心肌梗死（OR 1.86，95% CI 0.58 - 5.98）或输血（OR 1.36，95% CI 0.88 - 2.11）无关。
DM增加了子宫切除术后的感染风险。应特别关注糖尿病患者，以降低子宫切除术后并发症的发生率。
