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Anesth Analg 2000;91:1176-1181
© 2000 International Anesthesia Research Society

ECONOMICS AND HEALTH SYSTEMS RESEARCH

Longer-Term Diabetic Patients Have a More Frequent Incidence of Nosocomial Infections After Elective Gastrectomy

Soichiro Yamashita, MD*, Hiroshi Yamaguchi, MD*, Misa Sakaguchi, MD*, Tsuyoshi Satsumae, MD*, Sumii Yamamoto, MD*, and Fumiaki Shinya, MD{dagger}

Departments of *Anesthesia and Critical Care Medicine and {dagger}Surgery, Iwaki Kyoritsu General Hospital, Uchigo, Iwaki, Fukushima, Japan

Address correspondence and reprint requests to Hiroshi Yamaguchi, MD, Department of Anesthesia and Critical Care Medicine, Iwaki Kyoritsu General Hospital, Uchigo, Iwaki, Fukushima, 973-8555, Japan. Address e-mail to hyanchi{at}aol.com

Diabetes mellitus (DM) is one of the risk factors for the development of postoperative nosocomial infections in surgical patients. We conducted this retrospective study to elucidate the perioperative risk factors for postoperative nosocomial infections in diabetic patients undergoing elective gastrectomy. Chart review was performed on diabetic and nondiabetic patients undergoing elective gastrectomy for gastric malignancy from January 1992 through April 1999. Fourteen of the 83 diabetic patients, and 23 of the 284 nondiabetic patients developed postoperative nosocomial infections. Statistical comparisons of multiple variables were made between patients with and without postoperative nosocomial infections. In diabetic patients, univariate analysis showed that longer-term DM (especially longer than 10 yr) was associated with a significantly increased risk for postoperative nosocomial infections. Multiple logistic regression analysis showed that DM lasting longer than 10 yr was an independent risk factor for postoperative nosocomial infections (odds ratio, 6.8; 95% confidence interval, 1.7 to 27.1). In nondiabetic patients, similar analysis showed that age was an independent risk factor for postoperative nosocomial infections. We conclude that patients with longer-term DM had a significantly greater incidence of postoperative nosocomial infections after elective gastrectomy.

Implications: Postoperative nosocomial infection is one of the major problems in diabetic patients. This study demonstrated that postoperative nosocomial infections were more common in patients undergoing elective gastrectomy if they had diabetes mellitus longer than 10 yr.




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2000 by the International Anesthesia Research Society.