Association between acute phase perioperative glucose parameters and postoperative outcomes in diabetic and non-diabetic patients undergoing non-cardiac surgery.
Am J Surg
; 218(2): 302-310, 2019 08.
Article
em En
| MEDLINE
| ID: mdl-30343876
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 (Nâ¯=â¯1096) Higher glycemic variability was associated with longer hospital length of stay (0.32 day per 10â¯mg/dL) and greater 30-day mortality risk (ORâ¯=â¯1.42). Higher mean glucose (ORâ¯=â¯1.07) and glycemic variability (ORâ¯=â¯1.11) were associated with higher risk of complications. NON-DIABETIC PATIENTS (Nâ¯=â¯1012) Both higher mean glucose (0.29 day per 10â¯mg/dL) and higher glycemic variability (0.68 day per 10â¯mg/dL) were associated with longer hospital length of stay. Both higher mean glucose (ORâ¯=â¯1.13) and higher glycemic variability (ORâ¯=â¯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.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Complicações Pós-Operatórias
/
Glicemia
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Complicações do Diabetes
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Hiperglicemia
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article