Diabetes and Obesity as Risk Factors in Gastroenterological Surgery: according to the Analysis of Treatment Results
It is known that comorbidity significantly affects the development of diseases. Diabetes and obesity are common diseases. These diseases often occur in gastroenterological surgery. We conducted a retrospective analysis of the results of treatment of 135 patients. 53 patients had diabetes. 35 patients were obese. In 24 patients, diabetes was combined with obesity. 47 patients had no comorbidities. 17 patients had acute small intestinal obstruction. 22 patients had acute appendicitis. 25 patients had gastroduodenal perforation. 9 patients had bleeding ulcers. 27 patients had acute cholecystitis. 28 patients had acute cholecystitis. 7 patients had chronical pancreatitis. Surgery was applied to all patients. We found that patients with diabetes and obesity had an increased frequency of postoperative complications. Postoperative wound suppuration occurred in 2.7% of patients without comorbidity and in 9.5% of patients with diabetes and obesity (p<0.05). Leakage of anastomoses occurred in 1.7% of patients without comorbidities and in 5.3% of patients with diabetes and obesity. Local postoperative peritonitis was present in 1.07% of patients without comorbidities and in 1.34% of patients with diabetes and obesity. Diffuse postoperative peritonitis was present in 0.93% of patients without comorbidity and in 1.95% of patients with diabetes and obesity (p<0.05). Incisional hernia within 1 year after surgery was present in 3.17% of patients with diabetes and obesity. Patients without comorbidities did not have an incisional hernia for 1 year. 14.28% patient with acute small intestinal obstruction without comorbidities died. 23.81% patients with acute small intestinal obstruction and diabetes and obesity died. 11.11% patients with acute appendicitis and diabetes and obesity died. Patients with acute appendicitis without comorbidity did not die. 18.18% patients with gastroduodenal perforation and diabetes and obesity died. 16.28% patient? with gastroduodenal perforation without comorbidity died. 33.3% patients with bleeding ulcers and diabetes and obesity died. The cause of death was abdominal sepsis. Therefore, diabetes and obesity are significant risk factors in gastroenterological surgery. This should be taken into account when treating such patients. But the prognostic scales that are currently known such as Kalplan-Feinstein Index, ?harlson ?omorbidity Index, Adult Comorbidity Evaluation 27 score, Cumulative Illness Rating Scale, Index of Coexistent Diseases etc. are not sufficiently informative. Therefore, it is necessary to develop new prognostic scales. We developed a prognostic scale for emergency abdominal surgery that includes various types of comorbidities. According to the scale, 4 classes of comorbidity are distinguished. According to our data, the scale should be able to predict with an accuracy of up to 87%. To increase the accuracy of predicting such scales should be developed separately for each type of abdominal surgical disease.