Association Between Hypotension During Pancreatectomy and Development of Postoperative Diabetes
Main finding · Incident diabetesResult — go to the resultHazard ratio 1.48 95% CI 1.14–1.92Authors' conclusion
These results support the hypothesis that IOH during pancreatectomy may elevate risk of diabetes by inducing β-cell insufficiency.
Study context
- Population
- Patients without diabetes who underwent distal pancreatectomy or pancreaticoduodenectomy, January 2005–December 2018, 2 referral hospitals in Korea; average age 59 years, 49% men, 35% distal pancreatectomy
- Participants
- 1,129 patients
- Exposure
- Intraoperative hypotension duration: median duration vs 0 minutes
- Outcome
- Incident diabetes
- Follow-up
- Median 3.9 years
Methodological detailslongitudinal, 2 referral hospitals in Korea
- Longitudinal
- 2 referral hospitals in Korea
Main finding
As reported in the abstract
Hazard ratio
1.48
95% CI 1.14–1.92
Median IOH durationvs 0 minutes
HR 1.48 (95% CI 1.14–1.92)
- Diabetes developed
- 284 patients (25%)
- Cumulative incidence of diabetes proportional to increases in duration and depth of intraoperative hypotension (IOH)
- P < 0.001
- IOH occurred
- 83% (median duration, 25 minutes; IQR, 5-65)
Observational data: associations, not effects.
Secondary outcomes
Incident diabetes by procedure
- Effect of IOH pronounced with distal pancreatectomy
1-year Homeostatic Model Assessment (HOMA) β-cell function and HOMA insulin resistance
- Duration of IOH inversely correlated with 1-year HOMA β-cell function
- P < 0.002
- Duration of IOH not correlated with HOMA insulin resistance
Original publication
Association Between Hypotension During Pancreatectomy and Development of Postoperative Diabetes. J Clin Endocrinol Metab. Published 9 April 2024. doi:10.
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