High proportion of undiagnosed diabetes in patients surgically treated for infrarenal abdominal aortic aneurysm: findings from the multicentre Norwegian Aortic Aneurysm and Diabetes (ABANDIA) Study
Authors' conclusion
Twenty-five percent of all DM cases were undiagnosed at the time of AAA surgery. Based on post-hoc analyses, undiagnosed DM seems to be associated with an increased risk of organ related complications following AAA surgery. This study suggests universal DM screening in AAA patients to reduce the number of DM patients being undiagnosed and to improve proactive diabetes care in this population. The results from post-hoc analyses should be confirmed in future studies.
Study context
- Population
- Patients undergoing elective infrarenal open surgical (OSR) or endovascular (EVAR) Abdominal Aortic Aneurysm (AAA) repair, Norway, November 2017 to December 2020
- Participants
- 877 patients
- Exposure
- Diabetes mellitus (DM) vs no DM
- Outcome
- Total prevalence of known and undiagnosed DM
Methodological detailsmulticentre, preoperative HbA1c screening
- Multicentre
- Preoperative HbA1c screening
Main finding
As reported in the abstract
Total prevalence of DM
15%
95% CI 13%,17%
Undiagnosed upon admission, share of DM cases
25%
95% CI 18%,33%
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| In-hospital organ-related complications | OR 1.23 (95% CI 0.57,2.39) | P = 0.57 | |
| Procedure-related complications | OR 1.48 (95% CI 0.79,2.63) | P = 0.20 | |
| LOS | HR 1.06 (95% CI 0.88,1.28) | P = 0.54 | |
| Organ-related complications, newly diagnosed DM (n = 32)vs non-DMPost-hoc analysis | OR 4.92 (95% CI 1.53,14.3) | P = 0.005 | |
| 0.050.21520Ratio (log scale) |
- In-hospital organ-related complications — Organ-related complications, all patients (66 complications)
- 58 (7%)
- 30-day mortality · 30 days — Total 30-day mortality rate
- 0.6% (5/877) · P = 0.09
Distribution of OSR vs EVAR
- OSR to EVAR ratio
- 52% versus 48%
- Similar distribution among DM patients; no differences in prevalence of known and undiagnosed DM in EVAR vs OSR
Original publication
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