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. 2019 Aug;218(2):302-310.
doi: 10.1016/j.amjsurg.2018.10.024. Epub 2018 Oct 16.

Association between acute phase perioperative glucose parameters and postoperative outcomes in diabetic and non-diabetic patients undergoing non-cardiac surgery

Bala G Nair  1 , Moni B Neradilek  2 , Shu-Fang Newman  3 , Mayumi Horibe  4
Affiliations

Association between acute phase perioperative glucose parameters and postoperative outcomes in diabetic and non-diabetic patients undergoing non-cardiac surgery

Bala G Nair et al. Am J Surg. 2019 Aug.

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.

Keywords: Glycemic variability; Hyperglycemia; Perioperative; Postoperative outcome.

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