Influence of Diabetes Mellitus on Perioperative Outcomes Following Surgical Stabilization of Rib Fractures: A National Health Insurance Research Database Analysis.

Background and

Objectives

Diabetes mellitus (DM) significantly impacts post-surgical recovery and fracture healing; however, few studies have specifically investigated the impact of DM on outcomes in patients undergoing surgical stabilization of rib fractures (SSRF). This study investigated the potential influence of DM on perioperative outcomes following SSRF, using data from Taiwan's National Health Insurance Research Database (NHIRD). Materials and

Methods

Data of 1603 patients with multiple rib fractures who underwent SSRF between 2001 and 2019 were retrospectively analyzed. Patients were categorized into three groups: no DM, DM without chronic complications, and DM with chronic complications. The associations between DM status and perioperative outcomes, including hospital length of stay (LOS), in-hospital mortality, readmission rates, and complications such as pneumonia, surgical site infection (SSI), acute myocardial infarction (AMI), and total hospital costs were determined using univariate and multivariable regression analyses.

Results

The mean age of the 1603 patients was 52.0 years, and 71% were male. Patients with DM and chronic complications had higher risks of 14-day readmission (adjusted odds ratio [aOR] = 2.99; 95% confidence interval [CI]: 1.18-7.62), 15-30 day readmission (aOR = 3.28; 95% CI: 1.25-8.60), SSI (aOR = 2.90; 95% CI: 1.37-6.14), AMI (aOR = 3.44; 95% CI: 1.28-9.24), and acute respiratory distress syndrome (ARDS) (aOR = 1.96; 95% CI: 1.03-3.74). In conclusion, DM, particularly DM with chronic complications, significantly increases the risk of adverse short-term outcomes following SSRF.

Conclusions

These findings emphasize the need for enhanced care for patients with DM to optimize the outcomes of SSRF.