Intertrochanteric Fracture Surgery Patients with Diabetes Mellitus are Prone to Suffer Perioperative Neurological and Endocrine/Metabolic Complications: A Propensity-Score Matched Analysis

Figures & data

Figure 1 Flow diagram of included patients.

Table 1 Patient Characteristics at Baseline^§

Variables	Pre-Matching			Post-Matching
	Group A with DM (n=81)	Group B without DM (n=272)	p value	Group A with DM (n=80)	Group B without DM (n=80)	p value
Gender			0.165			0.607
Male	23 (28.4%)	100 (36.8%)		23 (28.7%)	26 (32.5%)
Female	58 (71.6%)	172 (63.2%)		57 (71.3%)	54 (67.5%)
Age	77.9±6.6	78.1±6.8	0.842	78.0±6.5	79.5±6.4	0.139
Age group			0.172			0.164
65–69	11 (13.6%)	46 (16.9%)		10 (12.5%)	7 (8.8%)
70–79	36 (44.4%)	90 (33.1%)		36 (45.0%)	27 (33.8%)
80–89	34 (42.0%)	136 (50.0%)		34 (42.5%)	46 (57.5%)
BMI			0.315			0.456
Normal	43 (53.1%)	170 (62.5%)		43 (53.8%)	50 (62.5%)
Overweight	28 (34.6%)	75 (27.6%)		27 (33.8%)	20 (25.0%)
Obesity	10 (12.3%)	27 (9.9%)		10 (12.4%)	10 (12.5%)
Injury mechanism			0.348			0.497
Fall	79 (97.5%)	256 (94.1%)		78 (97.5%)	80 (100.0%)
Violent	2 (2.5%)	16 (5.9%)		2 (2.5%)	0 (0.0%)
Fracture type			0.497			0.874
Stable	41 (50.6%)	126 (46.3%)		40 (50.0%)	41 (51.2%)
Unstable	40 (49.4%)	146 (53.7%)		40 (50.0%)	39 (48.8%)
ASA grade			<0.001*			0.095
I	0 (0.0%)	38 (14.0%)		0 (0.0%)	3 (3.8%)
II	16 (19.8%)	81 (29.8%)		16 (20.0%)	11 (13.8%)
III	38 (46.95)	91 (33.5%)		38 (47.5%)	28 (35.0%)
IV	24 (29.6%)	51 (18.8%)		23 (28.7%)	32 (40.0%)
V	3 (3.7%)	11 (4.0%)		3 (3.8%)	6 (7.5%)
Surgical delay	6.5±2.5	5.5±2.9	0.009*	6.5±2.5	6.0±3.2	0.269
Anesthesia type			0.446			0.342
General	36 (44.4%)	108 (39.7%)		35 (43.8%)	41 (51.2%)
Regional	45 (55.6%)	164 (60.3%)		45 (56.2%)	39 (48.8%)
Surgery duration	97.5±30.2	98.3±32.7	0.840	97.9±30.1	93.3±28.3	0.318
Intraoperative blood loss	200 (100, 300)	200 (100, 300)	0.292	200 (100, 300)	200 (100, 300)	0.593
Transfusion rate			0.767			0.593
Yes	57 (70.4%)	196 (72.1%)		57 (71.3%)	60 (75.0%)
No	24 (29.6%)	76 (27.9%)		23 (28.7%)	20 (25.0%)
Transfusion volume	2 (0, 6)	2 (0, 6)	0.790	2 (0, 6)	2 (0, 6)	0.761

Notes: ^§Values are presented as the number (%). Age, surgical delay, and surgery duration are presented as the mean ± standard deviation. Intraoperative blood loss is presented as the median (interquartile range). *p < 0.05, statistical significance.

Abbreviations: DM, diabetes mellitus; BMI, body mass index; ASA, American Society of Anesthesiologists.

Table 2 Patient Complications and Outcomes^§

Variables	Pre-Matching			Post-Matching
	Group A with DM (n=81)	Group B without DM (n=272)	p value	Group A with DM (n=80)	Group A without DM (n=80)	p value
Severe complications			0.670			0.593
Yes	20 (24.7%)	61 (22.4%)		20 (25.0%)	23 (28.7%)
No	61 (75.3%)	211 (77.6%)		60 (75.0%)	57 (71.3%)
Cardiac complications			0.046*			0.730
Yes	26 (32.1%)	58 (21.3%)		25 (31.3%)	23 (28.7%)
No	55 (67.9%)	214 (78.7%)		55 (68.8%)	57 (71.2%)
Pulmonary complications			0.909			0.184
Yes	9 (11.1%)	29 (10.7%)		9 (11.3%)	15 (18.8%)
No	72 (88.9%)	243 (89.3%)		71 (88.7%)	65 (81.2%)
Neurological complications			0.958			0.004*
Yes	7 (8.6%)	23 (8.5%)		7 (8.8%)	21 (26.3%)
No	74 (91.4%)	249 (91.5%)		73 (91.2%)	59 (73.7%)
Hematological complications			0.341			0.752
Yes	43 (53.1%)	128 (47.1%)		43 (53.8%)	41 (51.2%)
No	38 (46.9%)	144 (52.9%)		37 (46.2%)	39 (48.8%)
Endocrine/metabolic complications			<0.001*			<0.001*
Yes	81 (100.0%)	170 (62.5%)		80 (100.0%)	51 (63.7%)
No	0 (0.0%)	102 (37.5%)		0 (0.0%)	29 (36.3%)
Death			0.055*			0.123
Yes	20 (24.7%)	42 (15.4%)		20 (25.0%)	29 (36.3%)
No	61 (75.3%)	230 (84.6%)		60 (75.0%)	51 (63.7%)
30-day mortality			0.362			1.000
Yes	1 (1.2%)	1 (0.4%)		1 (1.3%)	1 (1.3%)
No	80 (98.8%)	271 (99.6%)		79 (98.8%)	79 (98.8%)
90-day mortality			0.453			0.493
Yes	3 (3.7%)	6 (2.2%)		3 (3.8%)	6 (7.5%)
No	78 (96.3%)	266 (97.8%)		77 (96.3%)	74 (92.5%)
1-year mortality			0.692			0.050
Yes	8 (9.9%)	23 (8.5%)		8 (10.0%)	17 (21.3%)
No	73 (90.1%)	249 (91.5%)		72 (90.0%)	63 (78.8%)
2-year mortality			0.105			0.053
Yes	17 (21.0%)	37 (13.6%)		17 (21.3%)	28 (35.0%)
No	64 (79.0%)	235 (86.4%)		63 (78.2%)	52 (65.0%)
THC	50397±17,461	49,350±17,992	0.644	50,529±17,531	53,460±22,992	0.366
LOS	13.7±4.6	13.7±5.9	0.995	13.7±4.6	14.2±6.2	0.583

Notes: ^§Values are presented as the number (%). THC and LOS are presented as the mean ± standard deviation. *p < 0.05, statistical significance.

Abbreviations: DM, diabetes mellitus; THC, total hospital costs; LOS, length of hospital stay.

Figure 2 Kaplan-Meier survival curves for older patients with or without diabetes mellitus after intertrochanteric fracture surgery. The Kaplan-Meier survival curve showed no significant difference between the two groups of patients on cumulative survival rate. (Figure 1, P = 0171, log-rank).