Panniculectomy and Diabetes: A Real World Study
Nathaniel T. Eberle, Devinder Singh, MD.
Anne Arundel Medical Center, Annapolis, MD, USA.
Abdominal Panniculectomy and the Preoperative Risk of Diabetes: A Real World Study
Authors: Nate Eberle, BS. Devinder Singh, MD.
Abstract
Background: Diabetes and obesity are increasing health risks; 29 million people in the United States alone having Diabetes, and 34% of American adults being considered obese. Panniculectomy is a common bariatric surgery that changes the form of the abdomen which can be effected by diabetes or obesity. Despite the known health risks, the relationship between panniculectomy and diabetes is not clearly defined. Our hypothesis is that diabetes and obesity will both increase the risk of complications following surgery. Our aim is to define the relationship between panniculectomy and diabetes/obesity.
Methods: Trinetx is a global health research network that provides statistics such as demographics, diagnoses, procedures, medications, labs, and genomics. Trinetx provides preoperative and postoperative deidentified patient information that is constantly updating itself. This study is a retrospective comparison of cohorts using trinetx that were analysed against a baseline to see if the rate of complications following panniculectomy was higher in certain patients.
Results: After balancing the diabetic and nondiabetic groups, there were 786 patients in each cohort. Patients with diabetes had a higher risk of dehiscence (95% confidence interval 2.11, 5.63, p<0.01), surgical site infection (95% confidence interval 2.82, 7.07, p<0.01), and hematoma/seroma (95% confidence interval 2.83, 7.07, p<0.01). The confidence interval crossed one for hernias, so no conclusion could be drawn. Obesity was also seen to be an independent risk factor for dehiscence (95% confidence interval 2.9, 5.81, p<0.01), surgical site infection (95% confidence interval 3.98, 7.37, p<0.01), and hematoma/seroma (95% confidence interval 1.18, 3.17, p<0.01). No conclusion could be drawn to correlate hernias and panniculectomy because the confidence inverval crossed one.
Conclusion: Our study is the first report in the surgical or wound literature to utilize TriNetX, a novel research network which democratizes data from EMRs. Obesity and diabetes were both shown to be independent risk factors for dehiscence, surgical site infection, and hematoma/seroma following a panniculectomy. These results show the importance of understanding the preoperative risks before undergoing a panniculectomy.
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