Diabetes mellitus (DM) is widely recognised as a significant prognostic factor influencing surgical outcomes. However, its specific impact on complications following hysterectomy has remained unclear. A recent study examined the relationship between DM and postoperative complications, aiming to clarify whether diabetic patients face higher risks after hysterectomy. A key finding reveals that diabetes doubles the risk of postoperative infection in this patient group.
To explore this, a systematic review and meta-analysis was conducted using data from PubMed, Embase, and the Cochrane Library up to 15 March 2024. Nineteen cohort studies involving 375,531 patients undergoing hysterectomy were included. Pooled odds ratios (ORs) and 95% CIs were calculated using a random effects model. The primary outcome focused on postoperative complications such as infections and hospital readmissions. Additional subgroup and sensitivity analyses were performed to assess heterogeneity and the robustness of the findings.
The results showed that diabetes significantly increased the risk of postoperative infection with an OR of 2.01 (95% CI: 1.46–2.77). Diabetic patients also had a higher likelihood of five-year mortality (OR: 4.43; 95% CI: 2.98–6.58), hospital readmission (OR 1.59; 95% CI: 1.42–1.79), embolism (OR: 1.31; 95% CI: 1.18–1.46), renal failure (OR: 3.88; 95% CI: 2.74–5.51), and reintubation (OR: 3.23; 95% CI: 1.64–6.35). There was no significant association between DM and prolonged hospital stay, myocardial infarction, or need for blood transfusion postoperatively.
These findings emphasise the importance of vigilant perioperative care for patients with diabetes undergoing hysterectomy to reduce postoperative infections and other serious complications. Limitations of this study include the reliance on observational cohort data, which may introduce confounding factors, and potential variability in diabetes management across included studies. Clinicians should consider enhanced monitoring and tailored interventions for diabetic patients to improve surgical outcomes and reduce readmission rates.
Reference
Zeng Y et al. The impact of diabetes on postoperative outcomes following hysterectomy: a systematic review and meta-analysis. BMC Womens Health. 2025;25(1):284
