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Diabetes Mellitus with Chronic Complications in Relation to Carotid Endarterectomy and Carotid Artery Stenting Outcomes.

Publication ,  Journal Article
Adegbala, O; Martin, KD; Otuada, D; Akinyemiju, T
Published in: J Stroke Cerebrovasc Dis
January 2017

BACKGROUND: Carotid endarterectomy and carotid artery stenting are effective treatment procedures for carotid artery stenosis. Although diabetes mellitus is highly prevalent among patients undergoing these revascularization procedures, few studies have examined their impact on periprocedural outcomes. OBJECTIVES: The study aimed to determine whether perioperative outcomes among patients undergoing carotid artery stenting and carotid endarterectomy varied depending on the presence of diabetes with or without chronic complications. METHODS: We examined adults aged 45 and above hospitalized between 2007 and 2011 in U.S. hospitals who underwent carotid artery revascularization procedures. We used data from the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample and evaluated the influence of diabetes with or without chronic complications on outcomes. RESULTS: Among patients receiving carotid artery stenting, diabetic patients with chronic complications had significantly increased odds of acute kidney injury (odds ratio [OR]: 3.17, 95% confidence interval [CI]: 2.31-4.35) and longer hospital stay (β: 1.98, 95% CI: 1.58-2.38) compared with nondiabetic patients. Diabetic patients with chronic complications receiving carotid endarterectomy experienced increased odds of myocardial infarction (OR: 1.12, 95% CI: .90-1.40), stroke (OR: 1.29, 95% CI: .97-1.72), perioperative infection (OR: 2.45, 95% CI: 1.29-4.65), mortality (OR: 1.48, 95% CI: 1.01-2.16), and longer hospital stay (β (days): 2.05, 95% CI: 1.90-2.20) compared with nondiabetic patients. No significant increased odds of perioperative outcomes were observed among diabetic patients without chronic complications. CONCLUSIONS: Uncomplicated diabetes did not appear to convey a higher odds of perioperative outcomes among patients undergoing revascularization. However, the presence of diabetes with chronic complications is an important risk factor in the carotid endarterectomy category.

Duke Scholars

Published In

J Stroke Cerebrovasc Dis

DOI

EISSN

1532-8511

Publication Date

January 2017

Volume

26

Issue

1

Start / End Page

217 / 224

Location

United States

Related Subject Headings

  • United States
  • Stents
  • Risk Assessment
  • Retrospective Studies
  • Postoperative Complications
  • Outcome Assessment, Health Care
  • Odds Ratio
  • Neurology & Neurosurgery
  • Myocardial Infarction
  • Middle Aged
 

Citation

APA
Chicago
ICMJE
MLA
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Adegbala, O., Martin, K. D., Otuada, D., & Akinyemiju, T. (2017). Diabetes Mellitus with Chronic Complications in Relation to Carotid Endarterectomy and Carotid Artery Stenting Outcomes. J Stroke Cerebrovasc Dis, 26(1), 217–224. https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.09.012
Adegbala, Oluwole, Kimberly D. Martin, David Otuada, and Tomi Akinyemiju. “Diabetes Mellitus with Chronic Complications in Relation to Carotid Endarterectomy and Carotid Artery Stenting Outcomes.J Stroke Cerebrovasc Dis 26, no. 1 (January 2017): 217–24. https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.09.012.
Adegbala O, Martin KD, Otuada D, Akinyemiju T. Diabetes Mellitus with Chronic Complications in Relation to Carotid Endarterectomy and Carotid Artery Stenting Outcomes. J Stroke Cerebrovasc Dis. 2017 Jan;26(1):217–24.
Adegbala, Oluwole, et al. “Diabetes Mellitus with Chronic Complications in Relation to Carotid Endarterectomy and Carotid Artery Stenting Outcomes.J Stroke Cerebrovasc Dis, vol. 26, no. 1, Jan. 2017, pp. 217–24. Pubmed, doi:10.1016/j.jstrokecerebrovasdis.2016.09.012.
Adegbala O, Martin KD, Otuada D, Akinyemiju T. Diabetes Mellitus with Chronic Complications in Relation to Carotid Endarterectomy and Carotid Artery Stenting Outcomes. J Stroke Cerebrovasc Dis. 2017 Jan;26(1):217–224.
Journal cover image

Published In

J Stroke Cerebrovasc Dis

DOI

EISSN

1532-8511

Publication Date

January 2017

Volume

26

Issue

1

Start / End Page

217 / 224

Location

United States

Related Subject Headings

  • United States
  • Stents
  • Risk Assessment
  • Retrospective Studies
  • Postoperative Complications
  • Outcome Assessment, Health Care
  • Odds Ratio
  • Neurology & Neurosurgery
  • Myocardial Infarction
  • Middle Aged