Lafayete William Ferreira Ramos1*, Beatriz Nery Nascimento2, Gabriel Rossi Silva2, Marcos Vinícius Ferreira Ramos3, Barbara Cristina Ferreira Ramos1, Cristiano Freitas de Souza1 and Pedro Amoedo Fernandes1
1São Camilo Oncologia, São Paulo, Brazil
2Centro Universitário São Camilo, São Paulo, Brazil
3Faculty of Medicine of Marilia, Marília, Brazil
Background: Systemic Hypertension (HTN) and Diabetes Mellitus (DM) are believed to be risk factors for adverse postoperative outcomes in patients undergoing surgical interventions, but evidence is lacking. This retrospective study evaluated the effects of HTN and DM, alone or in combination, on postoperative outcomes of elective non-cardiac surgery in cancer patients.
Materials and Methods: Patients (n=844) with malignancies, who underwent elective surgery at a tertiary hospital, were categorized into healthy (group A, n=339), hypertensive (group B, n=357), diabetic (group C, n=21), and hypertensive and diabetic (group D, n=127) groups. Preoperatively, all patients had systolic blood pressure ≤ 160 mmHg and plasma glucose level ≤ 140 mg/dl. Postoperative in-hospital morbidity and mortality were compared among groups.
Results: Postoperative complications occurred in 22 (6.5%), 21 (5.9%), 2 (9.5%), and 11 (8.7%) patients in groups A, B, C, and D, respectively (p=0.712). HTN (p=0.538), DM (p=0.990), and HTN+DM (p=0.135) did not impact the occurrence of adverse events. Patients with higher surgical risk (ASA III or IV) and those with longer surgical time had higher morbidity and mortality
(p=0.001, p<0.001, respectively). In multiple logistic regression analysis, ASA status and surgical time were independent risk factors for postoperative complications (both p<0.001).
Conclusion: Cancer patients with preoperative comorbidities, such as HTN and DM, alone or in combination, regardless of other characteristics, do not have an increased risk of adverse postoperative outcomes.
Diabetes mellitus; Hypertension; Oncologic surgery; Postoperative outcomes
Ramos LWF, Nascimento BN, Silva GR, Ramos MVF, Ramos BCF, de Souza CF, et al. Influence of Hypertension and Diabetes on Postoperative Outcomes in Cancer Patients Undergoing Moderate/High Risk Surgical Procedures. Clin Oncol. 2022;7:1934..