The impact of diabetes mellitus on postoperative outcomes following radical prostatectomy: a 5-year retrospective analysis

Objective Diabetes mellitus (DM) has been confirmed as a common risk factor for postoperative complications. This study aims to elucidate the impact of DM on postoperative complications following radical prostatectomy. Methods Using data from a national inpatient sample from 2016 to 2020, patients aged ≥ 18 years who were diagnosed with prostate cancer (PCa) and underwent radical prostatectomy were identified and divided into a DM group and a non-DM group. We further divided the DM group into uncomplicated DM and advanced DM groups. We compared the outcome variables between the three groups through univariate analysis and adjusted multivariate logistic regression. Results Seventeen thousand five hundred eighty-eight records were undergoing radical prostatectomy included in the present study, among which 2683 records (9.43%) had a diagnosis of DM. The DM group will incur higher costs (53,775 [38,286 − 65,482] vs. 51,546 [37,195 − 61,815] p < 0.001). After adjusting the variables with baseline differences in the multivariate regression models, DM was identified as an independent risk factor for unfavorable discharge (aOR = 1.20, 95%CI [1.02–1.42], P = 0.31), genitourinary complication (aOR = 1.40, 95%CI [1.13–1.73], P = 0.002), cardiac complication (aOR = 1.29, 95%CI [1.04–1.6], P = 0.019), and ventilatory support (aOR = 1.55, 95%CI [1.05–2.29], P = 0.028). After subgrouping the DM group by DM-related complications, the advanced DM group has more than double the risks of blood transfusion, genitourinary, and respiratory complications, compared to the non-DM group. Conclusion The findings suggest that DM is more likely to face adverse clinical outcomes and higher incidences of postoperative complications. It found that DM is an independent risk factor for adverse clinical outcomes after radical prostatectomy for cancer.