TY - JOUR
T1 - The relationship of preoperative versus postoperative hyperglycemia on clinical outcomes after elective colorectal surgery
AU - Chen, Edmund B.
AU - Nooromid, Michael J.
AU - Helenowski, Irene B.
AU - Soper, Nathaniel J.
AU - Halverson, Amy L.
N1 - Funding Information:
This article was partially supported by grant T32HL094293 from the National Heart, Lung, and Blood Institute of the National Institutes of Health in the form of partial stipend support for authors Edmund B. Chen, MD, and Michael J. Nooromid, MD, who were also partially supported by Abbot Fund. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors would also like to acknowledge Ming Zhang for his assistance and expertise in the data abstraction.
Funding Information:
This article was partially supported by grant T32HL094293 from the National Heart, Lung, and Blood Institute of the National Institutes of Health in the form of partial stipend support for authors Edmund B. Chen, MD, and Michael J. Nooromid, MD, who were also partially supported by Abbot Fund. The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors would also like to acknowledge Ming Zhang for his assistance and expertise in the data abstraction. The authors have indicated that they have no conflicts of interest regarding the content of this article.
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/10
Y1 - 2019/10
N2 - Background: The relationship between preoperative hyperglycemia and complications after surgery is not well defined. We compared the relationship of preoperative versus postoperative hyperglycemia on clinical outcomes and assessed if preoperative hyperglycemia was a predictor for postoperative hyperglycemia in patients undergoing elective colorectal surgery. Methods: We performed a retrospective review of an institutional database for patients who underwent elective colorectal resection between July 2015 and June 2017. Data regarding patient characteristics, history of diabetes, preoperative and postoperative hyperglycemic events, and postoperative complications were collected. Bivariate and multivariate logistic analyses were used to assess relationships. Results: Of 755 surgical operations reviewed, preoperative hyperglycemia >180 mg/dL was not significantly associated with adverse outcomes in an adjusted model. Only postoperative hyperglycemia >180 mg/dL was significantly associated with complications, including acute kidney injury (odds ratio 2.58, P < 0.001), anastomotic leak (odds ratio 2.64, P = 0.01), arrhythmia (odds ratio 2.40, P = 0.009), and sepsis (odds ratio 3.86, P < 0.001). Preoperative hyperglycemia remained a significant predictor of postoperative hyperglycemia (odds ratio 4.91, P < 0.001). Conclusion: Postoperative hyperglycemia was more significantly associated with adverse clinical outcomes after elective colorectal surgery than was preoperative hyperglycemia. However, preoperative hyperglycemia was associated with postoperative hyperglycemia, suggesting that improved glycemic management preoperatively may help reduce hyperglycemic events after surgery.
AB - Background: The relationship between preoperative hyperglycemia and complications after surgery is not well defined. We compared the relationship of preoperative versus postoperative hyperglycemia on clinical outcomes and assessed if preoperative hyperglycemia was a predictor for postoperative hyperglycemia in patients undergoing elective colorectal surgery. Methods: We performed a retrospective review of an institutional database for patients who underwent elective colorectal resection between July 2015 and June 2017. Data regarding patient characteristics, history of diabetes, preoperative and postoperative hyperglycemic events, and postoperative complications were collected. Bivariate and multivariate logistic analyses were used to assess relationships. Results: Of 755 surgical operations reviewed, preoperative hyperglycemia >180 mg/dL was not significantly associated with adverse outcomes in an adjusted model. Only postoperative hyperglycemia >180 mg/dL was significantly associated with complications, including acute kidney injury (odds ratio 2.58, P < 0.001), anastomotic leak (odds ratio 2.64, P = 0.01), arrhythmia (odds ratio 2.40, P = 0.009), and sepsis (odds ratio 3.86, P < 0.001). Preoperative hyperglycemia remained a significant predictor of postoperative hyperglycemia (odds ratio 4.91, P < 0.001). Conclusion: Postoperative hyperglycemia was more significantly associated with adverse clinical outcomes after elective colorectal surgery than was preoperative hyperglycemia. However, preoperative hyperglycemia was associated with postoperative hyperglycemia, suggesting that improved glycemic management preoperatively may help reduce hyperglycemic events after surgery.
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U2 - 10.1016/j.surg.2019.04.043
DO - 10.1016/j.surg.2019.04.043
M3 - Article
C2 - 31351669
AN - SCOPUS:85069628279
SN - 0039-6060
VL - 166
SP - 655
EP - 662
JO - Surgery
JF - Surgery
IS - 4
ER -
