Immediate post-resection diabetes mellitus after pancreaticoduodenectomy: Incidence and risk factors

Michael J. Ferrara, Christine Lohse, Yogish C. Kudva, Michael B. Farnell, Florencia G. Que, Kaye M. Reid-Lombardo, John H. Donohue, David M. Nagorney, Suresh T. Chari, Santhi S. Vege, Michael L. Kendrick

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Background: New-onset diabetes mellitus after a pancreaticoduodenectomy (PD) remains poorly defined. The aim of this study was to define the incidence and predictive factors of immediate post-resection diabetes mellitus (iPRDM). Methods: Retrospective review of patients undergoing PD from January 2004 through to July 2010. Immediate post-resection diabetes mellitus was defined as diabetes requiring pharmacological treatment within 30 days post-operatively. Logistic regression was conducted to identify factors predictive of iPRDM. Results: Of 778 patients undergoing PD, 214 were excluded owing to pre-operative diabetes (n= 192), declined research authorization (n= 14) or death prior to hospital discharge (n= 8); the remaining 564 patients comprised the study population. iPRDM occurred in 22 patients (4%) who were more likely to be male, have pre-operative glucose intolerance, or an increased creatinine, body mass index (BMI), pre-operative glucose, operative time, tumour size or specimen length compared with patients without iPRDM (P < 0.05). On multivariate analysis, pre-operative impaired glucose intolerance (P < 0.001), pre-operative glucose ≥ 126 (P < 0.001) and specimen length (P = 0.002) were independent predictors of iPRDM. A predictive model using these three factors demonstrated a c-index of 0.842. Discussion: New-onset, post-resection diabetes occurs in 4% of patients undergoing PD. Factors predictive of iPRDM include pre-operative glucose intolerance, elevated pre-operative glucose and increased specimen length. These data are important for patient education and predicting outcomes after PD.

Original languageEnglish (US)
Pages (from-to)170-174
Number of pages5
JournalHPB
Volume15
Issue number3
DOIs
StatePublished - Mar 2013

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Fingerprint Dive into the research topics of 'Immediate post-resection diabetes mellitus after pancreaticoduodenectomy: Incidence and risk factors'. Together they form a unique fingerprint.

  • Cite this

    Ferrara, M. J., Lohse, C., Kudva, Y. C., Farnell, M. B., Que, F. G., Reid-Lombardo, K. M., Donohue, J. H., Nagorney, D. M., Chari, S. T., Vege, S. S., & Kendrick, M. L. (2013). Immediate post-resection diabetes mellitus after pancreaticoduodenectomy: Incidence and risk factors. HPB, 15(3), 170-174. https://doi.org/10.1111/j.1477-2574.2012.00520.x