Allen D. Hamdan, M.D., and colleagues studied the records of 6,565 patients, roughly 62 percent of whom had diabetes, to see whether presence of the disease increased the risk of death or cardiac morbidity with major vascular surgery. All patients had procedures involving the carotid artery or aorta or peripheral vascular procedures to improve blood flow to the legs. Average age was 67.1 years among diabetic patients and 70.6 years among the patients without diabetes.

The researchers found that patients with diabetes had a lower rate of perioperative death than the patients without diabetes. No statistical differences were found after stratification by procedure type: aortic, carotid, or lower extremity. When comparing mortality, myocardial infarction, and congestive heart failure rates for both patient groups, the researchers found that the rate for all-cause postoperative death was 0.96 percent for the diabetic group versus 1.46 percent for the non-diabetic group. The rate of myocardial infarction was 1.77 percent for the diabetic group versus 1.30 percent in the non-diabetic group, and the rate for congestive heart failure was 1.13 percent in the diabetic group versus 1.14 percent in the non-diabetic group.

Although long-term survival was significantly lower for patients with diabetes, other factors were found to play a role in the perioperative period. Hemodialysis and a history of congestive heart failure were associated with increased mortality. Postoperative myocardial infarction was predicted only by previous infarctions.

According to background information in the article, diabetes has been identified as a minor predictor of negative postsurgical outcome. A significant proportion of vascular surgery patients have diabetes, which is a contributor to coronary and peripheral artery disease. Between 65 percent and 75 percent of deaths among persons with diabetes are attributed to macrovascular diseases including coronary artery disease.

"This single-institution study represents the first time, to our knowledge, that diabetes has not been found to be a clear predictor of perioperative death and morbidity after vascular surgery. The presence of diabetes should not preclude a patient from being considered for any vascular surgery procedure," conclude the researchers.