TY - JOUR
TI - Perioperative Hyperglycemia and Postoperative Outcomes in Patients Undergoing Resection of Colorectal Liver Metastases
AU - Margonis, G.A.
AU - Amini, N.
AU - Sasaki, K.
AU - Kim, Y.
AU - Merath, K.
AU - Buettner, S.
AU - Pikoulis, E.
AU - Andreatos, N.
AU - Wagner, D.
AU - Antoniou, E.
AU - Pawlik, T.M.
JO - Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
PY - 2017
VL - 21
TODO - 2
SP - 228-237
PB - Springer New York LLC
SN - 1091-255X, 1873-4626
TODO - 10.1007/s11605-016-3278-9
TODO - 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
TODO - 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.
ER -