Relationship of Perioperative Hyperglycemia and Postoperative Infections in Patients Who Undergo General and Vascular Surgery
Top Cited Papers
- 1 October 2008
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Annals of Surgery
- Vol. 248 (4), 585-591
- https://doi.org/10.1097/sla.0b013e31818990d1
Abstract
Evaluate the association of perioperative hyperglycemia and postoperative infections (POI) in patients who had undergone general surgery.Intensive glucose control leads to less postoperative infections (POI) in critically ill surgical patients, but the relationship of hyperglycemia and POI in a general surgical population remains unknown.A retrospective study of 995 patients who had undergone general and vascular surgery investigated the association of perioperative acute hyperglycemia and risk of 30-day POI over an 18-month period. The primary predictor of interest was postoperative glucose (POG). Bivariate analyses determined the association of each independent variable with POI. Factors significant at P < 0.05 were used in multivariable logistic regression models.In bivariate analyses, preoperative blood glucose (P = 0.012), POG (P = 0.009), age (P = 0.002), diabetes (P = 0.04), American Society of Anesthesia Classification (ASAC) (P < 0.0001), operation length (P = 0.02), and blood transfusions (P = 0.02) were significant predictors of POI. In multivariate analyses, only POG (OR = 1.3, (1.03-1.64)), ASAC (OR = 1.9, (1.31-2.83)), and emergency status (OR = 2.2, (1.21-3.80)) remained significant predictors of POI. Postoperative hyperglycemia increased the risk of POI by 30% with every 40-point increase from normoglycemia (200 mg/dL (OR = 1.8, (1.4-2.5)).The increased risk of POI and length of hospitalization posed by postoperative hyperglycemia is independent of diabetic status and needs further evaluation to assess for possible benefits of postoperative glycemic control in patients who have undergone general surgery.Keywords
This publication has 27 references indexed in Scilit:
- Poor postoperative blood glucose control increases surgical site infections after surgery for hepato-biliary-pancreatic cancer: a prospective study in a high-volume institute in JapanJournal of Hospital Infection, 2008
- Opportunities for Improved Performance in Surgical Specialty PracticeAnnals of Surgery, 2008
- Adverse Outcomes of Geriatric Patients Undergoing Abdominal Surgery Who Are at High Risk for DeliriumPublished by American Medical Association (AMA) ,2007
- The Diabetic Disadvantage: Historical Outcomes Measures in Diabetic Patients Undergoing Cardiac Surgery—The Pre-Intravenous Insulin EraSeminars in Thoracic and Cardiovascular Surgery, 2007
- Increased preoperative glucose levels are associated with perioperative mortality in patients undergoing noncardiac, nonvascular surgeryActa Endocrinologica, 2007
- A Prospective Study of Outcomes, Healthcare Resource Utilization, and Costs Associated With Postoperative Nosocomial InfectionsInfection Control & Hospital Epidemiology, 2006
- Intensive Insulin Therapy in the Medical ICUThe New England Journal of Medicine, 2006
- Impact of admission hyperglycemia on hospital mortality in various intensive care unit populations*Critical Care Medicine, 2005
- Perioperative Hyperglycemia Is a Strong Correlate of Postoperative Infection in Type II Diabetic Patients after Coronary Artery Bypass Grafting.Endocrine Journal, 2002
- Intensive Insulin Therapy in Critically Ill PatientsThe New England Journal of Medicine, 2001