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A Case-Control Study of Outcome

Mark S. Hickman, MD; Wayne H. Schwesinger, MD; Carey P. Page, MD

Arch Surg. 1988;123(4):409-411.

Abstract
• The influence of diabetes on the risks associated with the operative treatment of acute cholecystitis has not been clearly defined. Therefore, a case-control study of 72 diabetics requiring urgent operation for acute cholecystitis was undertaken. Patients were matched for age, gender, and date of surgery with nondiabetic controls. Review of patient records revealed no significant difference in hospital stay or severity of operative and pathologic findings. However, diabetics suffered significantly more morbidity (38.9%) than nondiabetics (20.8%). Moreover, diabetic infection-related complications occurred at a rate nearly three times that of controls (19.4% vs 6.9%). The only mortalities were experienced by diabetics (4.2%) and were the direct result of the effects of sepsis. These findings suggest that acute cholecystitis in diabetics is associated with a higher incidence of infection-related complications and supports the need for expeditious operative therapy in symptomatic patients.

(Arch Surg 1988;123:409-411)

Author Affiliations
From the Department of Surgery, University of Texas Health Science Center at San Antonio, and Audie L. Murphy Memorial Veterans Administration Hospital, San Antonio.

Footnotes
Accepted for publication Oct 1, 1987.

Read before the Association of Veterans Administration Surgeons, Portland, Ore, May 8, 1987.

Reprint requests to General Surgery (112G), Audie L. Murphy Memorial Veterans Administration Hospital, 7400 Merton Minter Blvd, San Antonio, TX 78284 (Dr Schwesinger).

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