Association between acute phase perioperative glucose parameters and postoperative outcomes in diabetic and non-diabetic patients undergoing non-cardiac surgery.
Glycemic variability
Hyperglycemia
Perioperative
Postoperative outcome
Journal
American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473
Informations de publication
Date de publication:
08 2019
08 2019
Historique:
received:
18
03
2018
revised:
03
10
2018
accepted:
12
10
2018
pubmed:
23
10
2018
medline:
23
1
2020
entrez:
23
10
2018
Statut:
ppublish
Résumé
The relationship between acute phase perioperative hyperglycemia and postoperative outcome is poorly understood. Retrospective cohort study of diabetic and non-diabetic adult patients undergoing non-cardiac surgery. Mean glucose and glycemic variability during the intraoperative and immediate postoperative periods were compared to length of stay, 30-day mortality, and postoperative complications. . DIABETIC PATIENTS (N = 1096): Higher glycemic variability was associated with longer hospital length of stay (0.32 day per 10 mg/dL) and greater 30-day mortality risk (OR = 1.42). Higher mean glucose (OR = 1.07) and glycemic variability (OR = 1.11) were associated with higher risk of complications. NON-DIABETIC PATIENTS (N = 1012): Both higher mean glucose (0.29 day per 10 mg/dL) and higher glycemic variability (0.68 day per 10 mg/dL) were associated with longer hospital length of stay. Both higher mean glucose (OR = 1.13) and higher glycemic variability (OR = 1.21) were associated with greater risks of complications. Poor acute phase perioperative glycemic control is associated with poor outcome, but differently in diabetic and non-diabetic patients suggesting different glycemic management strategies for the two patient groups.
Sections du résumé
BACKGROUND
The relationship between acute phase perioperative hyperglycemia and postoperative outcome is poorly understood.
METHODS
Retrospective cohort study of diabetic and non-diabetic adult patients undergoing non-cardiac surgery. Mean glucose and glycemic variability during the intraoperative and immediate postoperative periods were compared to length of stay, 30-day mortality, and postoperative complications.
RESULTS
. DIABETIC PATIENTS (N = 1096): Higher glycemic variability was associated with longer hospital length of stay (0.32 day per 10 mg/dL) and greater 30-day mortality risk (OR = 1.42). Higher mean glucose (OR = 1.07) and glycemic variability (OR = 1.11) were associated with higher risk of complications. NON-DIABETIC PATIENTS (N = 1012): Both higher mean glucose (0.29 day per 10 mg/dL) and higher glycemic variability (0.68 day per 10 mg/dL) were associated with longer hospital length of stay. Both higher mean glucose (OR = 1.13) and higher glycemic variability (OR = 1.21) were associated with greater risks of complications.
CONCLUSIONS
Poor acute phase perioperative glycemic control is associated with poor outcome, but differently in diabetic and non-diabetic patients suggesting different glycemic management strategies for the two patient groups.
Identifiants
pubmed: 30343876
pii: S0002-9610(18)30430-6
doi: 10.1016/j.amjsurg.2018.10.024
pii:
doi:
Substances chimiques
Blood Glucose
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
302-310Informations de copyright
Copyright © 2018 Elsevier Inc. All rights reserved.