@article{3126443,
    title = "Perioperative Hyperglycemia and Postoperative Outcomes in Patients Undergoing Resection of Colorectal Liver Metastases",
    author = "Margonis, G.A. and Amini, N. and Sasaki, K. and Kim, Y. and Merath, K. and Buettner, S. and Pikoulis, E. and Andreatos, N. and Wagner, D. and Antoniou, E. and Pawlik, T.M.",
    journal = "Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract",
    year = "2017",
    volume = "21",
    number = "2",
    pages = "228-237",
    publisher = "Springer New York LLC",
    issn = "1091-255X, 1873-4626",
    doi = "10.1007/s11605-016-3278-9",
    keywords = "aged;  analysis;  blood;  colorectal tumor;  complication;  diabetes mellitus;  female;  glucose blood level;  human;  hyperglycemia;  liver resection;  liver tumor;  male;  middle aged;  pathology;  perioperative period;  postoperative period;  retrospective study;  secondary;  treatment outcome, Aged;  Blood Glucose;  Colorectal Neoplasms;  Diabetes Mellitus;  Female;  Hepatectomy;  Humans;  Hyperglycemia;  Liver Neoplasms;  Male;  Middle Aged;  Perioperative Period;  Postoperative Period;  Retrospective Studies;  Treatment Outcome",
    abstract = "Introduction: There is limited evidence characterizing the impact of glycemic alterations on short-term outcomes among patients undergoing resection of colorectal liver metastases (CRLM). Methods: Hyperglycemia was defined as a glucose value >125 mg/dl according to WHO definition. The impact of early postoperative hyperglycemia on short-term postoperative outcomes was assessed. Results: The mean postoperative glucose value was 128 mg/dl; 30 (9.8 %) patients had normal fasting glucose (<100 mg/dl), 106 patients had glucose intolerance (100–125 mg/dl), and 170 (55.5 %) patients had hyperglycemia (>125 mg/dl). A postoperative complication occurred in 101 patients (morbidity, 33.1 %); among patients who experienced a complication, an infectious complication was most common (38.6 %). After controlling for clinical factors, patients with hyperglycemia had an increased risk of overall complications [odds ratio (OR) 4.11; 95 % confidence interval (CI) 1.96–8.62, P < 0.001]. This was the case for both patients with and without diabetes (P < 0.05). Patients with hyperglycemia on the day of surgery were also at an increased risk of infections [OR 9.17; 95 % CI 2.26–37.13, P = 0.002] and had a longer hospital stay (normal glucose, 4 days vs. glucose 100–125 mg/dl, 4 days vs. glucose >125 mg/dl, 5 days, P < 0.001). Conclusions: Early postoperative hyperglycemia was associated with adverse outcomes in patients with and without diabetes who underwent resection of CRLM. Perioperative glucose evaluation may be an important quality target. © 2016, The Society for Surgery of the Alimentary Tract."
}