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The influence of pre-admission hypoglycaemic therapy on cardiac morbidity and mortality in type 2 diabetic patients undergoing major non-cardiac surgery: a prospective observational study*

Bolliger, D. and Seeberger, M. D. and Lurati Buse, G. and Christen, P. and Seeberger, E. and Ruppen, W. and Filipovic, M.. (2012) The influence of pre-admission hypoglycaemic therapy on cardiac morbidity and mortality in type 2 diabetic patients undergoing major non-cardiac surgery: a prospective observational study*. Anaesthesia, Vol. 67. pp. 149-157.

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Official URL: http://edoc.unibas.ch/dok/A6007012

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Abstract

It remains unclear whether type 2 diabetics treated with either insulin or oral hypoglycaemic agents have the same incidence of cardiac morbidity and mortality after major non-cardiac surgery. We prospectively studied 360 type 2 diabetic patients undergoing major non-cardiac surgery of which 105 were treated with insulin only, 171 were treated with oral hypoglycaemics only and 84 were treated with a combination of insulin and oral hypoglycaemics. All-cause mortality after 30?days and after 12?months was highest in the insulin (10% and 26%) and lowest in the oral hypoglycaemics group (2% and 13%; p = 0.02 and 0.007, respectively). Insulin treatment was independently associated with increased mortality after 30?days (hazard ratio 3.93; 95% CI 1.22-12.64; p?=?0.022) and 12?months (hazard ratio 2.03; 95% CI 1.16-3.58; p?=?0.014) after multivariate adjustment for age, sex and the revised cardiac risk index (insulin treatment excluded). The increased mortality in insulin-treated diabetic patients may be due to a more progressive disease state in these patients rather than the treatment modality itself.
Faculties and Departments:03 Faculty of Medicine > Bereich Querschnittsfächer (Klinik) > Anästhesiologie
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Querschnittsfächer (Klinik) > Anästhesiologie
UniBasel Contributors:Seeberger-Stucky, Manfred and Filipovic, Miodrag
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Pulman
ISSN:0003-2409
Note:Publication type according to Uni Basel Research Database: Journal article
Last Modified:26 Apr 2013 07:03
Deposited On:26 Apr 2013 07:00

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