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High proportion of undiagnosed diabetes in patients surgically treated for infrarenal abdominal aortic aneurysm: findings from the multicentre Norwegian Aortic Aneurysm and Diabetes (ABANDIA) Study.
- Source :
-
Cardiovascular diabetology [Cardiovasc Diabetol] 2024 Sep 09; Vol. 23 (1), pp. 333. Date of Electronic Publication: 2024 Sep 09. - Publication Year :
- 2024
-
Abstract
- Background: The aim was to investigate the total prevalence of known and undiagnosed diabetes mellitus (DM), and the association of DM with perioperative complications following elective, infrarenal, open surgical (OSR) or endovascular (EVAR), Abdominal Aortic Aneurysm (AAA) repair.<br />Methods: In this Norwegian prospective multicentre study, 877 patients underwent preoperative screening for DM by HbA <subscript>1c</subscript> measurements from November 2017 to December 2020. Diabetes was defined as screening detected HbA <subscript>1c</subscript> ≥ 48 mmol/mol (6.5%) or previously diagnosed diabetes. The association of DM with in-hospital complications, length of stay, and 30-day mortality rate were evaluated using adjusted and unadjusted logistic regression models.<br />Results: The total prevalence of DM was 15% (95% CI 13%,17%), of which 25% of the DM cases (95% CI 18%,33%) were undiagnosed upon admission for AAA surgery. The OSR to EVAR ratio was 52% versus 48%, with similar distribution among DM patients, and no differences in the prevalence of known and undiagnosed DM in the EVAR versus the OSR group. Total 30-day mortality rate was 0.6% (5/877). Sixty-six organ-related complications occurred in 58 (7%) of the patients. DM was not statistically significantly associated with a higher risk of in-hospital organ-related complications (OR 1.23, 95% CI 0.57,2.39, p = 0.57), procedure-related complications (OR 1.48, 95% CI 0.79,2.63, p = 0.20), 30-day mortality (p = 0.09) or length of stay (HR 1.06, 95% CI 0.88,1.28, p = 0.54). According to post-hoc-analyses, organ-related complications were more frequent in patients with newly diagnosed DM (n = 32) than in non-DM patients (OR 4.92; 95% CI 1.53,14.3, p = 0.005).<br />Conclusion: Twenty-five percent of all DM cases were undiagnosed at the time of AAA surgery. Based on post-hoc analyses, undiagnosed DM seems to be associated with an increased risk of organ related complications following AAA surgery. This study suggests universal DM screening in AAA patients to reduce the number of DM patients being undiagnosed and to improve proactive diabetes care in this population. The results from post-hoc analyses should be confirmed in future studies.<br /> (© 2024. The Author(s).)
- Subjects :
- Humans
Male
Female
Aged
Prospective Studies
Prevalence
Risk Factors
Norway epidemiology
Risk Assessment
Time Factors
Treatment Outcome
Aged, 80 and over
Blood Vessel Prosthesis Implantation adverse effects
Blood Vessel Prosthesis Implantation mortality
Glycated Hemoglobin metabolism
Length of Stay
Middle Aged
Undiagnosed Diseases epidemiology
Undiagnosed Diseases diagnosis
Hospital Mortality
Aortic Aneurysm, Abdominal surgery
Aortic Aneurysm, Abdominal mortality
Aortic Aneurysm, Abdominal diagnostic imaging
Aortic Aneurysm, Abdominal epidemiology
Diabetes Mellitus epidemiology
Diabetes Mellitus diagnosis
Diabetes Mellitus mortality
Endovascular Procedures adverse effects
Endovascular Procedures mortality
Postoperative Complications mortality
Postoperative Complications etiology
Postoperative Complications epidemiology
Biomarkers blood
Subjects
Details
- Language :
- English
- ISSN :
- 1475-2840
- Volume :
- 23
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Cardiovascular diabetology
- Publication Type :
- Academic Journal
- Accession number :
- 39252002
- Full Text :
- https://doi.org/10.1186/s12933-024-02421-w