Impact of diabetes mellitus on the frequency of post-operative complications after carotid endarterectomy

Cardiovasc J Afr. 2023;34(4):237-241. doi: 10.5830/CVJA-2022-054. Epub 2022 Nov 9.

Abstract

Background: There is significant controversy surrounding the link between diabetes mellitus and post-operative complications after carotid endarterectomy (CEA). The aim of this study was to identify the possible effects of diabetes on the frequency of post-operative complications after CEA.

Methods: This prospective study was conducted at the Dedinje Clinic for Vascular Surgery, Belgrade. The patients who underwent CEA were divided into two groups: group A (37.7%) included 98 (35.1%) insulin-dependent and 181 (64.9%) insulin-independent diabetic patients, and group B (62.3%) comprised non-diabetic subjects.

Results: The pre-operative characteristics were similar, except for a greater prevalence of dyslipidaemia in patients with diabetes. Post-operative cardiac events occurred more often in patients with diabetes (3.6%) than in non-diabetic patients (1.1%) (p = 0.039); post-operative neurological events among patients with diabetes were 3.6% and among non-diabetics, 0.9% (p = 0.009). Peri-operative mortality rate was 2.5% in the diabetic group and 0.9% in the non-diabetic group. The total percentage of post-operative complications was two or more times higher in the diabetic group than the non-diabetic group (8.5 vs 18.3%, p < 0.001).

Conclusions: Diabetes mellitus increased the surgical risk of CEA. Higher rates of mortality and post-operative complications were observed in patients being treated with oral antidiabetics than in those on insulin.

Keywords: carotid endarterectomy; diabetes mellitus; post‐operative complications.

MeSH terms

  • Carotid Stenosis* / complications
  • Diabetes Mellitus* / diagnosis
  • Diabetes Mellitus* / drug therapy
  • Diabetes Mellitus* / epidemiology
  • Endarterectomy, Carotid* / adverse effects
  • Humans
  • Insulin / therapeutic use
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Prospective Studies
  • Retrospective Studies
  • Risk Factors
  • Stroke*
  • Treatment Outcome

Substances

  • Insulin