The Impacts of Diabetes Mellitus on Clinical Outcomes of Hospitalization Following Craniotomy for Brain Tumor
Yu Hong, Pengyuan Zhang, Jiewen Jin, Weiwei Liang, Junxin Chen, Juan Liu, Hongyu Guan, Zijun Huo, Hai LiBackground
Diabetes mellitus (DM) is a common comorbidity in patients undergoing neurosurgical procedures and has been associated with adverse surgical outcomes. However, the extent to which DM, particularly the presence of chronic diabetic complications, affects perioperative outcomes and healthcare utilization in patients undergoing craniotomy for brain tumors remains unclear. Clarifying this relationship is essential for perioperative risk stratification and optimization.
Methods
We conducted a retrospective cohort study using the National Inpatient Sample (NIS) database, identifying adults (≥18 years) who underwent craniotomy for brain tumors between 2016 and 2022. Patients were stratified into three groups: non-DM, DM without chronic complications, and DM with chronic complications. Outcomes included in-hospital mortality, postoperative complications, length of stay (LOS), discharge disposition, and hospitalization costs.
Results
A total of 49,100 patients were included, of whom 8,822 (18.1%) had DM. Overall, DM patients experienced higher rates of postoperative complications, longer LOS, increased non-routine discharge, and greater hospitalization costs compared with non-DM patients. Notably, patients with DM without chronic complications had outcomes comparable to those of non-DM patients. In contrast, DM patients with chronic complications demonstrated significantly higher risks of adverse outcomes across all measured endpoints.
Conclusions
DM alone does not significantly worsen outcomes after craniotomy for brain tumors. However, the presence of chronic diabetic complications is strongly associated with increased perioperative morbidity, mortality, prolonged hospitalization, and higher healthcare costs. These findings underscore the importance of incorporating diabetic complication status into preoperative evaluation and targeted perioperative management strategies.