Insulin-Dependent Diabetes Increases Risk for Postoperative Complications

(HealthDay News) — Patients with insulin-dependent diabetes have an increased risk for a number of postoperative complications after lumbar fusion compared with those who have noninsulin-dependent diabetes or no diabetes, according to a study published in Spine.

Nicholas S. Golinvaux, from Yale University in New Haven, Connecticut, and colleagues retrospectively analyzed data from the American College of Surgeons National Surgical Quality Improvement Program database and identified 15,480 patients who underwent lumbar fusion between 2005 and 2012.

Patients were characterized as having noninsulin-dependent diabetes (n=1,650), insulin-dependent diabetes (n=787) or neither (n=13,043).

Noninsulin-dependent diabetes was independently associated with an increased risk for wound dehiscence (relative risk [RR]=2.3) and extended length of stay (RR=1.2).

There were independent associations between insulin-dependent diabetes and increased risk for death (RR=2.7), sepsis (RR=2.2), septic shock (RR=3.3), unplanned intubation (RR=2.8), ventilator-assisted respiration for more than 48 hours postoperatively (RR=2.8), wound-related infection (RR=1.9), urinary tract infection (RR=1.6), pneumonia (RR=3.1), extended length of stay (RR=1.5) and readmission within 30 days (RR=1.5).

“This important designation may improve preoperative risk stratification and counseling of patients with diabetes prior to lumbar fusion surgery,” the researchers concluded.

Relevant financial activities outside the submitted work were disclosed: consultancy, expert testimony, grants.


  1. Golinvaux NS et al. Spine. 2014;39(21):1809-1816.