Splenectomy in trauma patients is associated with an increased risk of postoperative type II diabetes: a nationwide population-based study

Am J Surg. 2014 Nov;208(5):811-816. doi: 10.1016/j.amjsurg.2014.03.003. Epub 2014 May 2.

Abstract

Background: Animal studies indicate that splenocytes may act as precursors of β-islet secretory cells in the pancreas. This study aimed to assess the risk of postoperative type II diabetes after splenectomy in trauma patients.

Methods: We used data from the Taiwan National Health Insurance hospitalized claims. Study 1 included 3,723 patients receiving splenectomy and 3,723 matched patients receiving other types of abdominal surgery. Study 2 included 5,996 patients with spleen injury and 5,996 matched patients with other types of abdominal injury. The hazard ratio for diabetes was estimated using the matched Cox proportional hazard regression model.

Results: In trauma patients after surgery, those who received splenectomy had a 2-fold higher risk of diabetes compared with patients without splenectomy after a 3-year follow-up period. In the nonoperative group, there was no difference in diabetes risk between patients with splenic injury and those with other types of injury.

Conclusions: Splenectomy was associated with an increased risk of postoperative type II diabetes in trauma patients. Thus, there may be a role for the spleen in the development of diabetes.

Keywords: Postoperative diabetes; Splenectomy; Trauma.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Injuries / surgery*
  • Adult
  • Aged
  • Aged, 80 and over
  • Databases, Factual
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / etiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Postoperative Complications* / epidemiology
  • Proportional Hazards Models
  • Risk Factors
  • Spleen / injuries*
  • Spleen / surgery
  • Splenectomy*
  • Treatment Outcome