Post Operative mortality in cancer patients with preexisting diabetes: systematic review and meta-analysis.

Abstract

OBJECTIVE: Diabetes Appears to Increase risk for some cancers, but the Association Between preexisting diabetes and post operative mortality in cancer patients is less clear. Our Objective was to systematically review post-operative mortality in cancer patients with and without preexisting diabetes and Summarize Using meta-analysis results. RSEARCH DESIGN AND METHODS: We searched the Medical Literature Analysis and Retrieval System Online (MEDLINE) and Excerpta Medica Database (EMBASE) for articles published on or before 1 July 2009, include references or qualifying articles. We included English language Investigation of short-term post-operative mortality after initial cancer treatment. Titles, abstracts, and articles Were reviewed by at least two independent readers. Study population and design, results, and quality components with standard protocols Were abstracted by one reviewer and checked for accuracy by Additional reviewers.

RESULTS: Of 8828 titles Identified in our original search, 20 articles with inclusion criteria for Qualitative systematic review. Or thesis, 15 Reported information sufficient is to be combined in meta-analysis. Preexisting diabetes was associated with Increased odds or post-operative mortality across all types of cancer (OR = 1.85 [95% CI 1.40-2.45]). The risk associated with preexisting diabetes was attenuated but remained significant When we restricted the meta-analysis to models controlled for confounders That (1.51 [1.13-2.02]) or When We accounted for publication bias Using the trim and fill method (1.52 [1.13- 2.04]).

CONCLUSIONS: Compared with nondiabetic Their counterparts, cancer patients with preexisting diabetes are approximately 50% more Likely to die after surgery. Future Research Should Investigate physiologic pathways to mortality risk and determining whethere improvements in perioperative diabetes care can-reducing post operative mortality.