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Perioperative glycemic status is linked to postoperative complications in non-intensive care unit patients with type-2 diabetes : a retrospective study

Oba, Takeshi ; Nagao, Mototsugu LU ; Kobayashi, Shunsuke ; Yamaguchi, Yuji ; Nagamine, Tomoko ; Tanimura-Inagaki, Kyoko ; Fukuda, Izumi and Sugihara, Hitoshi (2022) In Therapeutic Advances in Endocrinology and Metabolism 13. p.1-14
Abstract

BACKGROUND: Perioperative hyperglycemia is a risk factor for postoperative complications in the general population. However, it has not been clarified whether perioperative hyperglycemia increases postoperative complications in patients with type-2 diabetes mellitus (T2D). Therefore, we aimed to analyze the relationship between perioperative glycemic status and postoperative complications in non-intensive care unit (non-ICU) hospitalized patients with T2D.

MATERIALS AND METHODS: Medical records of 1217 patients with T2D who were admitted to the non-ICU in our hospital were analyzed retrospectively. Relationships between clinical characteristics including perioperative glycemic status and postoperative complications were assessed... (More)

BACKGROUND: Perioperative hyperglycemia is a risk factor for postoperative complications in the general population. However, it has not been clarified whether perioperative hyperglycemia increases postoperative complications in patients with type-2 diabetes mellitus (T2D). Therefore, we aimed to analyze the relationship between perioperative glycemic status and postoperative complications in non-intensive care unit (non-ICU) hospitalized patients with T2D.

MATERIALS AND METHODS: Medical records of 1217 patients with T2D who were admitted to the non-ICU in our hospital were analyzed retrospectively. Relationships between clinical characteristics including perioperative glycemic status and postoperative complications were assessed using univariate and multivariate analyses. Perioperative glycemic status was evaluated by calculating the mean, standard deviation (SD), and coefficient of variation (CV) of blood glucose (BG) measurements in preoperative and postoperative periods for three contiguous days before and after surgery, respectively. Postoperative complications were defined as infections, delayed wound healing, postoperative bleeding, and/or thrombosis.

RESULTS: Postoperative complications occurred in 139 patients (11.4%). These patients showed a lower BG immediately before surgery (P = 0.04) and a higher mean postoperative BG (P = 0.009) than those without postoperative complications. There were no differences in the other perioperative BG parameters including BG variability and the frequency of hypoglycemia. The multivariate analysis showed that BG immediately before surgery (adjusted odds ratio (95% confidence interval [CI]), 0.91 (0.85-0.98), P = 0.01) and mean postoperative BG (1.11 (1.05-1.18), P < 0.001) were independently associated with postoperative complications.

CONCLUSION: Perioperative glycemic status, that is, a low BG immediately before surgery and a high mean postoperative BG, are associated with the increased incidence of postoperative complications in non-ICU patients with T2D.

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author
; ; ; ; ; ; and
publishing date
type
Contribution to journal
publication status
published
in
Therapeutic Advances in Endocrinology and Metabolism
volume
13
pages
1 - 14
publisher
SAGE Publications
external identifiers
  • scopus:85130696299
  • pmid:35646304
ISSN
2042-0188
DOI
10.1177/20420188221099349
language
English
LU publication?
no
additional info
© The Author(s), 2022.
id
eff31388-4ad0-455b-a55f-b8800acc0a7e
date added to LUP
2023-01-12 02:05:06
date last changed
2024-06-13 14:57:09
@article{eff31388-4ad0-455b-a55f-b8800acc0a7e,
  abstract     = {{<p>BACKGROUND: Perioperative hyperglycemia is a risk factor for postoperative complications in the general population. However, it has not been clarified whether perioperative hyperglycemia increases postoperative complications in patients with type-2 diabetes mellitus (T2D). Therefore, we aimed to analyze the relationship between perioperative glycemic status and postoperative complications in non-intensive care unit (non-ICU) hospitalized patients with T2D.</p><p>MATERIALS AND METHODS: Medical records of 1217 patients with T2D who were admitted to the non-ICU in our hospital were analyzed retrospectively. Relationships between clinical characteristics including perioperative glycemic status and postoperative complications were assessed using univariate and multivariate analyses. Perioperative glycemic status was evaluated by calculating the mean, standard deviation (SD), and coefficient of variation (CV) of blood glucose (BG) measurements in preoperative and postoperative periods for three contiguous days before and after surgery, respectively. Postoperative complications were defined as infections, delayed wound healing, postoperative bleeding, and/or thrombosis.</p><p>RESULTS: Postoperative complications occurred in 139 patients (11.4%). These patients showed a lower BG immediately before surgery (P = 0.04) and a higher mean postoperative BG (P = 0.009) than those without postoperative complications. There were no differences in the other perioperative BG parameters including BG variability and the frequency of hypoglycemia. The multivariate analysis showed that BG immediately before surgery (adjusted odds ratio (95% confidence interval [CI]), 0.91 (0.85-0.98), P = 0.01) and mean postoperative BG (1.11 (1.05-1.18), P &lt; 0.001) were independently associated with postoperative complications.</p><p>CONCLUSION: Perioperative glycemic status, that is, a low BG immediately before surgery and a high mean postoperative BG, are associated with the increased incidence of postoperative complications in non-ICU patients with T2D.</p>}},
  author       = {{Oba, Takeshi and Nagao, Mototsugu and Kobayashi, Shunsuke and Yamaguchi, Yuji and Nagamine, Tomoko and Tanimura-Inagaki, Kyoko and Fukuda, Izumi and Sugihara, Hitoshi}},
  issn         = {{2042-0188}},
  language     = {{eng}},
  pages        = {{1--14}},
  publisher    = {{SAGE Publications}},
  series       = {{Therapeutic Advances in Endocrinology and Metabolism}},
  title        = {{Perioperative glycemic status is linked to postoperative complications in non-intensive care unit patients with type-2 diabetes : a retrospective study}},
  url          = {{http://dx.doi.org/10.1177/20420188221099349}},
  doi          = {{10.1177/20420188221099349}},
  volume       = {{13}},
  year         = {{2022}},
}