Association between acute phase perioperative glucose parameters and postoperative outcomes in diabetic and non-diabetic patients undergoing non-cardiac surgery - 13/07/19
, Moni B. Neradilek b , Shu-Fang Newman a , Mayumi Horibe c Abstract |
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.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Poor acute phase perioperative glucose management is associated with poor outcomes. |
• | Higher glucose level and glycemic variability are associated with poor outcomes in non-diabetic patients. |
• | Only higher glycemic variability associated with poor outcomes in diabetic patients. |
• | Diabetic and non-diabetic patients show different perioperative glycemic responses. |
• | They likely require different glycemic management strategies and glucose targets. |
Keywords : Hyperglycemia, Glycemic variability, Perioperative, Postoperative outcome
Plan
Vol 218 - N° 2
P. 302-310 - août 2019 Retour au numéro
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