Diabetes Is Associated with Lower In-Hospital Mortality in Patients Undergoing Surgical Repair for Aortic Aneurysm...

Area of Science:

• Cardiovascular Surgery
• Endocrinology
• Public Health

Background:

• Previous research suggested type 2 diabetes (T2D) confers a protective effect on aortic aneurysm progression.
• The impact of T2D on outcomes following surgical repair of ruptured aortic aneurysms (rAA) remains under investigation.

Purpose of the Study:

• To determine if the protective effect of T2D persists in patients undergoing surgical repair for ruptured abdominal or thoracic aortic aneurysms.
• To analyze in-hospital and 30-day mortality and readmission rates in diabetic versus non-diabetic patients with rAA.

Main Methods:

• Analysis of data from the US Nationwide Readmission Database (2016-2019).
• Inclusion of patients admitted for surgical repair of ruptured abdominal or thoracic aortic aneurysms.
• Follow-up of discharged patients for 30 days to assess co-primary outcomes: in-hospital and 30-day mortality.

Main Results:

• Among 9858 patients, 16.4% had diabetes. Diabetic patients exhibited lower adjusted in-hospital mortality for both abdominal and thoracic aneurysms (aOR=0.76 and aOR=0.61, respectively).
• Diabetes was associated with increased risks of atrial fibrillation (aOR=1.25) and acute renal failure (aOR=1.17).
• No significant difference in 30-day mortality or readmission was observed between groups (aHR=1.47 and aHR=1.15, respectively). Infections were more frequent in the diabetes group (16.0% vs. 11.0%).

Conclusions:

• The paradoxical protective effect of type 2 diabetes is evident in surgically treated ruptured aortic aneurysms, indicated by lower in-hospital mortality.
• This benefit does not translate to improved 30-day survival or reduced readmission rates.
• Increased incidence of infections in diabetic patients warrants further attention.