Τίτλος:
Perioperative Hyperglycemia and Postoperative Outcomes in Patients Undergoing Resection of Colorectal Liver Metastases
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Margonis, G.A.
Amini, N.
Sasaki, K.
Kim, Y.
Merath, K.
Buettner, S.
Pikoulis, E.
Andreatos, N.
Wagner, D.
Antoniou, E.
Pawlik, T.M.
Περιοδικό:
Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Εκδότης:
Springer New York LLC
Λέξεις-κλειδιά:
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
DOI:
10.1007/s11605-016-3278-9
