P103 - THE POSTOPERATIVE OUTCOMES IN PATIENTS WITH AND WITHOUT DIABETES UNDERGOING GASTROINTESTINAL SURGERY: A PROSPECTIVE OBSERVATIONAL COHORT STUDY

P103

THE POSTOPERATIVE OUTCOMES IN PATIENTS WITH AND WITHOUT DIABETES UNDERGOING GASTROINTESTINAL SURGERY: A PROSPECTIVE OBSERVATIONAL COHORT STUDY

A. Adiamah^1,*, S. Quraishi¹, T. G. Wong¹, D. Evans², A. Banerjea¹, D. N. Lobo¹ on behalf of The Nottingham University Hospitals HBA1c Working Group

¹Gastrointestinal Surgery, Nottingham Digestive Diseases Centre and National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals and University of Nottingham, Queen’s Medical Centre, ²Anaesthesia, Nottingham University Hospitals and University of Nottingham, Queen’s Medical Centre, Nottingham, United Kingdom

Rationale: This study aimed to compare the postoperative outcomes in patients with and without diabetes undergoing gastrointestinal surgery.

Methods: This single centre prospective observational study was conducted between 1 September 2022 and 1 September 2023. It included all patients undergoing gastrointestinal surgery who had a pre- or immediate postoperative glycated haemoglobin (HbA1c) measurements. The demographic characteristics of patients with and without diabetes, were compared as was the postoperative outcomes of total hospital length of stay, complications, and mortality.

Results: In total, 1901 patients (362 with diabetes and 1539 without diabetes) were included in this study. Higher proportions of patients with diabetes were older, male and more likely to be obese (p<0.001), with a higher median (IQR) HbA1c [53 (45-67) mmol/mol vs. 35 (32-38) mmol/mol, (p<0.001)]. Regarding complexity of surgery, patients with diabetes were more likely to be undergoing “Minor or Intermediate surgery” (52.8%) as opposed to “Major or Complex major surgery”.  They had longer intensive care unit and total hospital lengths of stay than those without diabetes. Proportionally they had higher rates of postoperative complications (29.1% vs 23.5%, but this was not statistically significant). Whilst overall mortality at 90-days was low, patients with diabetes had a 5-fold increased risk of mortality compared with those without diabetes at 90-days on multivariate logistical regression (adjusted odds ratio 5.00, 95% CI 2.06–12.17, P < 0.001).

Conclusion: Patients with diabetes had worse postoperative outcomes, including increased complications, prolonged hospital stays, and higher risk of mortality. The high median HbA1c in this patient group suggests that better preoperative optimisation, better glycaemic control, and focused perioperative interventions may improve outcomes.

Disclosure of Interest: None declared