Clinical Science | Endocrine

Mohammad Hussein, Eman Toraih, Zaid Alquarashi, Abdallah Attia, Emad Kandil

ePoster Presenter: Mohammad Hussein Msc, MD, Tulane School of Medicine

Background: Diabetic patients often have several comorbidities and face a higher risk of poor outcomes following major surgeries.  While many thyroid and parathyroid surgeries are elective, ambulatory, and short-duration procedures, the physiologic stress of these surgeries may still adversely affect diabetic patients.

Objectives: We hypothesized that the post-operative course of diabetic patients may be more complicated compared to non-diabetic patients after thyroid and parathyroid surgeries.

Methods: We evaluated 53,334 thyroid and 15,262 parathyroid surgery patients from 2010-2014, using Nationwide Readmission Database. Univariate and multivariate analyses were performed on diabetic vs. non-diabetic cohort for post-operative complications, length of stay (LOS), readmission rate, and hospital costs.

Results: 8,480 thyroid surgery patients (15.9%) and 2,945 parathyroid surgery patients (19.3%) were identified with diabetes mellitus as a comorbid condition.  Diabetic patients showed higher risk of post-operative complications (OR: 1.16, 95%CI: 1.06-1.27, P=0.002) and 30-days readmission rate (OR: 1.27, 95%CI: 1.18-1.37, P≤0.001).  Diabetic patients also exhibited prolonged LOS (OR: 1.14, 95%CI: 1.02-1.27) and incurred higher overall hospital costs (OR: 1.11, 95%CI: 1.02-1.21, P=0.010) than the non-diabetic cohort.  Older age (>45 years), Charlson Comorbidity Index ≥ 2, and presence of metabolic syndrome were independent predictors of a higher rate of complications such as bleeding, infection, or end-organ dysfunction (p<0.05).

Conclusion: Diabetic patients face unique challenges even when undergoing elective thyroid or parathyroid surgeries.  These low-risk procedures are associated with a higher risk of complications, prolonged LOS, and higher costs when performed for diabetic patients.  Future studies of this population are warranted to ensure quality outcomes and to reduce healthcare expenditures.