Diabetes prolongs hospitalization and increases infection, cerebral edema, and neurological complications in meningioma patients: A retrospective study.

BACKGROUND: Diabetes is linked to extended hospitalization and a heightened risk of complications in multiple surgical settings. However, its precise influence on outcomes in patients undergoing meningioma resection is still inadequately comprehended. AIM: To determine if diabetes prolongs hospital stay and elevates the risk of infection, cerebral edema, and neurological complications in patients undergoing meningioma resection. METHODS: A retrospective study was conducted on 516 primary meningioma patients who underwent surgical resection between January 2018 and January 2022. Patients were categorized into non-diabetes (n = 411) and diabetes (n = 105) groups according to a clinical history of type 2 diabetes for a minimum of 6 months preceding diagnosis. The collected data encompassed baseline demographics, perioperative variables, blood glucose levels, inflammatory markers, brain edema grading, Karnofsky Performance Status, length of stay, and postoperative complications. RESULTS: Significant differences in glycated hemoglobin levels were observed, with elevated values in the diabetes group (P < 0.05). The diabetes group exhibited higher rates of secondary or tertiary wound healing complications due to infection, lower postoperative albumin, higher postoperative platelet counts, white blood cell counts, C-reactive protein levels, and tumor necrosis factor-alpha levels (all P < 0.05). The diabetes group exhibited higher incidence of postoperative cerebral edema (P = 0.015), lower postoperative Karnofsky Performance Status scores (P = 0.011), longer hospital stays (P < 0.001), and longer intensive care unit stays (P < 0.001). Additionally, the diabetes group exhibited higher rates of seizures (P = 0.003) and wound infections (P < 0.001) and more complications (P < 0.001). Long-term outcomes showed higher tumor recurrence (P = 0.004) and mortality rates (P = 0.036) in the diabetes group, corroborated by Cox regression analysis as independent risk factors (recurrence: Adjusted hazard ratio = 8.92, P = 0.009; mortality: Adjusted hazard ratio = 10.12, P = 0.048). CONCLUSION: Diabetes markedly extends hospital stay and elevates the risk of infection, cerebral edema, and neurological complications in patients with meningioma, underscoring the necessity for meticulous perioperative management and long-term follow-up for diabetic individuals undergoing meningioma surgery.