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

Table 1 Comparison of demographic information between two groups, n (%)/mean ± SD

Parameters	Diabetics group (n = 105)	Non-diabetics group (n = 411)	t/χ2	P value
Age (years)	55.14 ± 6.65	56.46 ± 7.44	1.653	0.099
Body mass index (kg/m2)	28.72 ± 4.53	28.93 ± 3.25	0.451	0.652
Gender			0.058	0.809
Male	43 (40.95)	163 (39.66)
Female	62 (59.05)	248 (60.34)
Ethnicity			0.227	0.634
Han	97 (92.38)	385 (93.67)
Other	8 (7.62)	26 (6.33)
Education level			0.825	0.364
High school or below	79 (75.24)	326 (79.32)
Tertiary and above	26 (24.76)	85 (20.68)
Residence location			0.082	0.775
Rural	35 (33.33)	131 (31.87)
Urban	70 (66.67)	280 (68.13)
Income level (thousand/month)	3.74 ± 1.45	3.98 ± 1.21	1.551	0.123

Table 2 Comparison of clinical characteristics between two groups of patients, n (%)/mean ± SD

Parameters	Diabetics group (n = 105)	Non-diabetics group (n = 411)	t/χ2	P value
Tumor location			0.143	0.705
Convexity/falx	62 (59.05)	251 (61.07)
Skull base	43 (40.95)	160 (38.93)
Tumor max diameter (cm)	4.23 ± 0.54	4.26 ± 0.41	0.515	0.607
Tumor max diameter stratification			0.072	0.789
Less than 5 cm	67 (63.81)	268 (65.21)
Greater than or equal to 5 cm	38 (36.19)	143 (34.79)
World Health Organization grade			0.794	0.672
I	76 (72.38)	303 (73.72)
II	21 (20.00)	86 (20.92)
III	8 (7.62)	22 (5.35)
Postoperative follow-up (months)	38.72 ± 1.02	38.71 ± 1.21	0.050	0.960
Glycated hemoglobin (%)	7.01 ± 0.46	4.45 ± 0.56	48.368	< 0.001
Duration of diabetes (years)	3.56 ± 1.04	-

Table 3 Comparison of perioperative period between two groups of patients, n (%)

Parameters	Diabetics group (n = 105)	Non-diabetics group (n = 411)	χ2	P value
Extent of surgical resection			0.209	0.648
GTR	83 (79.05)	333 (81.02)
No GTR	22 (20.95)	78 (18.98)
Infection requiring washout	9 (8.57)	21 (5.11)	1.830	0.176
Hematoma requiring evacuation	2 (1.90)	1 (0.24)	1.637	0.201
Hydrocephalus requiring shunt	2 (1.90)	1 (0.24)	1.637	0.201

GTR: Gross total resection.

Table 4 Comparison of infection between two groups of patients, n (%)/mean ± SD

Parameters	Diabetics group (n = 105)	Non-diabetics group (n = 411)	t/χ2	P value
Grading of wound healing			35.698	< 0.001
Primary wound healing without infection	73 (69.52)	376 (91.48)
Secondary and tertiary wound healing with infection	32 (30.48)	35 (8.52)
Pre-operative blood glucose (mg/dL)	151.54 ± 17.61	119.85 ± 15.93	17.795	< 0.001
Post-operative blood glucose (mg/dL)	190.50 ± 14.20	189.70 ± 12.40	0.572	0.568
Preoperative albumin (mg/L)	378.42 ± 13.41	379.52 ± 13.51	0.750	0.454
Postoperative albumin (mg/L)	291.78 ± 13.10	300.97 ± 13.72	6.185	< 0.001
Preoperative platelet count (109/L)	145.52 ± 7.41	145.42 ± 6.68	0.134	0.894
Postoperative platelet count (109/L)	269.08 ± 6.62	266.67 ± 7.44	3.019	0.003
Preoperative white blood cell count (109/L)	5.93 ± 1.24	5.83 ± 1.31	0.671	0.502
Postoperative white blood cell count (109/L)	15.61 ± 4.98	14.52 ± 3.63	2.104	0.037
Preoperative CRP (mg/L)	3.21 ± 1.31	2.96 ± 1.01	1.815	0.072
Postoperative CRP (mg/L)	133.94 ± 18.12	128.63 ± 18.24	2.664	0.008
Preoperative IL-6 (ng/mL)	20.53 ± 2.23	20.16 ± 2.63	1.475	0.142
Postoperative IL-6 (ng/mL)	28.42 ± 5.67	27.26 ± 5.41	1.945	0.052
Preoperative TNF-α (pg/mL)	51.35 ± 7.56	50.85 ± 7.78	0.591	0.555
Postoperative TNF-α (pg/mL)	61.17 ± 7.42	59.31 ± 7.52	2.267	0.024

CRP: C-Reactive Protein; IL-6: Interleukin-6; TNF-α: Tumor necrosis factor-alpha.

Table 5 Comparison of cerebral edema between two groups of patients, n (%)

Parameters	Diabetics group (n = 105)	Non-diabetics group (n = 411)	χ2	P value
Preoperative cerebral edema	12 (11.43)	48 (11.68)	0.005	0.943
Postoperative cerebral edema	27 (25.71)	64 (15.57)	5.923	0.015
Postoperative cerebral edema worsens	21 (20.00)	62 (15.09)	1.497	0.221
Symptomatic cerebral edema	11 (10.48)	32 (7.79)	0.792	0.373
Cerebral edema requiring intervention	8 (7.62)	8 (1.95)	7.168	0.007

Table 6 Comparison of postoperative complications between two groups of patients, n (%)

Parameters	Diabetics group (n = 105)	Non-diabetics group (n = 411)	χ2	P value
Seizure	13 (12.38)	19 (4.62)	8.654	0.003
External ventricular drainage/ventriculoperitoneal shunt	2 (1.90)	2 (0.49)	0.732	0.392
Any SSI	8 (7.62)	2 (0.49)	18.792	< 0.001
Superficial incisional SSI	5 (4.76)	1 (0.24)
Deep incisional SSI	3 (2.86)	1 (0.24)
Organ/space SSI	0 (0)	0 (0)
Cerebrovascular accident	7 (6.67)	12 (2.92)	2.339	0.126
Urinary tract infection	3 (2.86)	4 (0.97)	1.034	0.309
Transfusion	2 (1.90)	3 (0.73)	0.290	0.590
Pneumonia	3 (2.86)	4 (0.97)	1.034	0.309
Deep vein thrombosis	2 (1.90)	2 (0.49)	0.732	0.392
Any complications	33 (31.43)	42 (10.22)	30.286	< 0.001

SSI: Surgical site infection.

Table 7 Comparison of long-term outcomes between two groups of patients, n (%)

Parameters	Diabetics group (n = 105)	Non-diabetics group (n = 411)	χ2	P value
Tumor recurrence rate	5 (4.76)	2 (0.49)	8.452	0.004
Mortality rate	3 (2.86)	1 (0.24)	4.419	0.036

Table 8 Cox regression analysis of factors associated with long-term outcomes

Outcome	Variable	Univariable analysis HR (95%CI)	P value	Multivariable analysis HR (95%CI)	P value
Tumor recurrence	Diabetes	9.45 (1.84-48.47)	0.007	8.92 (1.73-45.87)	0.009
	Age	1.02 (0.94-1.11)	0.623	1.02 (0.94-1.11)	0.642
	WHO grade (II/III)	1.58 (0.31-8.07)	0.583	1.42 (0.27-7.38)	0.677
	Extent of surgical resection (non-GTR)	2.15 (0.42-10.97)	0.356	1.89 (0.37-9.71)	0.445
Mortality	Diabetes	11.45 (1.18-111.18)	0.036	10.12 (1.00-102.55)	0.048
	Age	1.06 (0.95-1.18)	0.288	1.06 (0.95-1.18)	0.295
	WHO grade (II/III)	2.11 (0.19-23.10)	0.543	1.75 (0.16-19.33)	0.650
	Extent of surgical resection (non-GTR)	3.01 (0.27-33.10)	0.365	2.56 (0.23-28.65)	0.443

GTR: Gross total resection; HR: Hazard ratio; WHO: World Health Organization.