Abstract
Association Between Diabetes Mellitus and Intraoperative Awareness During General Anesthesia: A Retrospective Cohort Study
International journal of medical students, v 13, S184
31 Dec 2025
Abstract
Background: Despite advancements in anesthetic techniques, specific patient populations remain vulnerable to intraoperative awareness. Diabetes mellitus (DM), increasingly prevalent and often accompanied by significant comorbidities, may complicate anesthetic management and mask signs of inadequate anesthetic depth. This study investigates whether DM is independently associated with an increased risk of unintended intraoperative awareness. Methods: A retrospective cohort analysis was conducted using the TriNetX research platform, a federated health database. Two cohorts were identified: patients with DM and a control group without DM undergoing surgery under general anesthesia. Propensity-score matching (1:1) was used to control for confounders, including cognitive impairment, chronic obstructive pulmonary disease, substance use, cardiovascular disease, and anesthesia type. The incidence of intraoperative awareness was compared between groups. Results: After matching, 193,868 patients were included in each cohort (total n=387,736). The incidence of intraoperative awareness was significantly higher in the DM group (0.027%, n=52) compared to the non-DM group (0.015%, n=29). DM was associated with a statistically significant increased risk (absolute risk difference: 0.012%, 95% CI: 0.003–0.021%, p=0.0106). Diabetic patients had nearly twice the risk of intraoperative awareness (RR=1.793, 95% CI: 1.139–2.824; OR=1.793, 95% CI: 1.139–2.825). Conclusion: DM significantly increases the risk of intraoperative awareness during general anesthesia. These findings underscore the importance of heightened anesthetic vigilance and personalized monitoring strategies in diabetic patients to mitigate this risk. Table 1. Comparison of Intraoperative Awareness Incidence Between Diabetic and non-Diabetic Cohorts. Cohort Patients in Cohort Patients with Outcome Risk Diabetes Cohort 193,868 52 0.027% Non-Diabetic Control Cohort 193,868 29 0.015% Risk Difference 95% CI (Risk Diff) z p Risk Ratio 95% CI (Risk Ratio) Odds Ratio 95% CI (Odds Ratio) 0.012% (0.003%, 0.021%) 2.556 0.0106 1.793 (1.139, 2.824) 1.793 (1.139, 2.825)
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Details
- Title
- Association Between Diabetes Mellitus and Intraoperative Awareness During General Anesthesia: A Retrospective Cohort Study
- Creators
- Zhenghao Wang - Drexel UniversityNgoc Bich Nguyen - Drexel University, College of MedicineEduardo Espiridion - Reading Hospital
- Publication Details
- International journal of medical students, v 13, S184
- Publisher
- University of Pittsburgh
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- Psychiatry; College of Medicine
- Other Identifier
- 991022152137204721