Cargando…
The prevalence of hyperglycemia and its association with perioperative outcomes in gynecologic surgery: a retrospective cohort study
BACKGROUND: Preoperative hyperglycemia has been associated with perioperative morbidity in general surgery patients. Additionally, preoperative hyperglycemia may indicate underlying impaired glucose metabolism. Thus, identification of preoperative hyperglycemia may provide an opportunity to mitigate...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10236760/ https://www.ncbi.nlm.nih.gov/pubmed/37268985 http://dx.doi.org/10.1186/s13741-023-00307-1 |
_version_ | 1785053013154463744 |
---|---|
author | Chaves, Katherine F. Panza, Joseph R. Olorunfemi, Mutiya A. Helou, Christine M. Apple, Annie N. Zhao, Zhiguo Sorabella, Laura L. Dumas, Susan D. Adam, Rony A. Prescott, Lauren S. |
author_facet | Chaves, Katherine F. Panza, Joseph R. Olorunfemi, Mutiya A. Helou, Christine M. Apple, Annie N. Zhao, Zhiguo Sorabella, Laura L. Dumas, Susan D. Adam, Rony A. Prescott, Lauren S. |
author_sort | Chaves, Katherine F. |
collection | PubMed |
description | BACKGROUND: Preoperative hyperglycemia has been associated with perioperative morbidity in general surgery patients. Additionally, preoperative hyperglycemia may indicate underlying impaired glucose metabolism. Thus, identification of preoperative hyperglycemia may provide an opportunity to mitigate both short-term surgical and long-term health risk. We aimed to study this phenomenon specifically in the gynecologic surgery population. Specifically, we aimed to evaluate the association between preoperative hyperglycemia and perioperative complications in gynecologic surgery patients and to characterize adherence to diabetes screening guidelines. METHODS: This retrospective cohort study included 913 women undergoing major gynecologic surgery on an enhanced recovery pathway from January 2018 to July 2019. The main exposure was day of surgery glucose ≥ 140 g/dL. Multivariate regression identified risk factors for hyperglycemia and composite and wound-specific complications. RESULTS: Sixty-seven (7.3%) patients were hyperglycemic. Diabetes (aOR 24.0, 95% CI 12.3–46.9, P < .001) and malignancy (aOR 2.3, 95% CI 1.2–4.5, P = .01) were associated with hyperglycemia. Hyperglycemia was not associated with increased odds of composite perioperative (aOR 1.3, 95% CI 0.7–2.4, P = 0.49) or wound-specific complications (aOR 1.1, 95% CI 0.7–1.5, P = 0.76). Of nondiabetic patients, 391/779 (50%) met the USPSTF criteria for diabetes screening; 117 (30%) had documented screening in the preceding 3 years. Of the 274 unscreened patients, 94 (34%) had day of surgery glucose levels suggestive of impaired glucose metabolism (glucose ≥ 100 g/dL). CONCLUSION: In our study cohort, the prevalence of hyperglycemia was low and was not associated with higher risk of composite or wound-specific complications. However, adherence to diabetes screening guidelines was poor. Future studies should aim to develop a preoperative blood glucose testing strategy that balances the low utility of universal glucose screening with the benefit of diagnosing impaired glucose metabolism in at-risk individuals. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13741-023-00307-1. |
format | Online Article Text |
id | pubmed-10236760 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-102367602023-06-03 The prevalence of hyperglycemia and its association with perioperative outcomes in gynecologic surgery: a retrospective cohort study Chaves, Katherine F. Panza, Joseph R. Olorunfemi, Mutiya A. Helou, Christine M. Apple, Annie N. Zhao, Zhiguo Sorabella, Laura L. Dumas, Susan D. Adam, Rony A. Prescott, Lauren S. Perioper Med (Lond) Research BACKGROUND: Preoperative hyperglycemia has been associated with perioperative morbidity in general surgery patients. Additionally, preoperative hyperglycemia may indicate underlying impaired glucose metabolism. Thus, identification of preoperative hyperglycemia may provide an opportunity to mitigate both short-term surgical and long-term health risk. We aimed to study this phenomenon specifically in the gynecologic surgery population. Specifically, we aimed to evaluate the association between preoperative hyperglycemia and perioperative complications in gynecologic surgery patients and to characterize adherence to diabetes screening guidelines. METHODS: This retrospective cohort study included 913 women undergoing major gynecologic surgery on an enhanced recovery pathway from January 2018 to July 2019. The main exposure was day of surgery glucose ≥ 140 g/dL. Multivariate regression identified risk factors for hyperglycemia and composite and wound-specific complications. RESULTS: Sixty-seven (7.3%) patients were hyperglycemic. Diabetes (aOR 24.0, 95% CI 12.3–46.9, P < .001) and malignancy (aOR 2.3, 95% CI 1.2–4.5, P = .01) were associated with hyperglycemia. Hyperglycemia was not associated with increased odds of composite perioperative (aOR 1.3, 95% CI 0.7–2.4, P = 0.49) or wound-specific complications (aOR 1.1, 95% CI 0.7–1.5, P = 0.76). Of nondiabetic patients, 391/779 (50%) met the USPSTF criteria for diabetes screening; 117 (30%) had documented screening in the preceding 3 years. Of the 274 unscreened patients, 94 (34%) had day of surgery glucose levels suggestive of impaired glucose metabolism (glucose ≥ 100 g/dL). CONCLUSION: In our study cohort, the prevalence of hyperglycemia was low and was not associated with higher risk of composite or wound-specific complications. However, adherence to diabetes screening guidelines was poor. Future studies should aim to develop a preoperative blood glucose testing strategy that balances the low utility of universal glucose screening with the benefit of diagnosing impaired glucose metabolism in at-risk individuals. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13741-023-00307-1. BioMed Central 2023-06-02 /pmc/articles/PMC10236760/ /pubmed/37268985 http://dx.doi.org/10.1186/s13741-023-00307-1 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Chaves, Katherine F. Panza, Joseph R. Olorunfemi, Mutiya A. Helou, Christine M. Apple, Annie N. Zhao, Zhiguo Sorabella, Laura L. Dumas, Susan D. Adam, Rony A. Prescott, Lauren S. The prevalence of hyperglycemia and its association with perioperative outcomes in gynecologic surgery: a retrospective cohort study |
title | The prevalence of hyperglycemia and its association with perioperative outcomes in gynecologic surgery: a retrospective cohort study |
title_full | The prevalence of hyperglycemia and its association with perioperative outcomes in gynecologic surgery: a retrospective cohort study |
title_fullStr | The prevalence of hyperglycemia and its association with perioperative outcomes in gynecologic surgery: a retrospective cohort study |
title_full_unstemmed | The prevalence of hyperglycemia and its association with perioperative outcomes in gynecologic surgery: a retrospective cohort study |
title_short | The prevalence of hyperglycemia and its association with perioperative outcomes in gynecologic surgery: a retrospective cohort study |
title_sort | prevalence of hyperglycemia and its association with perioperative outcomes in gynecologic surgery: a retrospective cohort study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10236760/ https://www.ncbi.nlm.nih.gov/pubmed/37268985 http://dx.doi.org/10.1186/s13741-023-00307-1 |
work_keys_str_mv | AT chaveskatherinef theprevalenceofhyperglycemiaanditsassociationwithperioperativeoutcomesingynecologicsurgeryaretrospectivecohortstudy AT panzajosephr theprevalenceofhyperglycemiaanditsassociationwithperioperativeoutcomesingynecologicsurgeryaretrospectivecohortstudy AT olorunfemimutiyaa theprevalenceofhyperglycemiaanditsassociationwithperioperativeoutcomesingynecologicsurgeryaretrospectivecohortstudy AT helouchristinem theprevalenceofhyperglycemiaanditsassociationwithperioperativeoutcomesingynecologicsurgeryaretrospectivecohortstudy AT appleannien theprevalenceofhyperglycemiaanditsassociationwithperioperativeoutcomesingynecologicsurgeryaretrospectivecohortstudy AT zhaozhiguo theprevalenceofhyperglycemiaanditsassociationwithperioperativeoutcomesingynecologicsurgeryaretrospectivecohortstudy AT sorabellalaural theprevalenceofhyperglycemiaanditsassociationwithperioperativeoutcomesingynecologicsurgeryaretrospectivecohortstudy AT dumassusand theprevalenceofhyperglycemiaanditsassociationwithperioperativeoutcomesingynecologicsurgeryaretrospectivecohortstudy AT adamronya theprevalenceofhyperglycemiaanditsassociationwithperioperativeoutcomesingynecologicsurgeryaretrospectivecohortstudy AT prescottlaurens theprevalenceofhyperglycemiaanditsassociationwithperioperativeoutcomesingynecologicsurgeryaretrospectivecohortstudy AT chaveskatherinef prevalenceofhyperglycemiaanditsassociationwithperioperativeoutcomesingynecologicsurgeryaretrospectivecohortstudy AT panzajosephr prevalenceofhyperglycemiaanditsassociationwithperioperativeoutcomesingynecologicsurgeryaretrospectivecohortstudy AT olorunfemimutiyaa prevalenceofhyperglycemiaanditsassociationwithperioperativeoutcomesingynecologicsurgeryaretrospectivecohortstudy AT helouchristinem prevalenceofhyperglycemiaanditsassociationwithperioperativeoutcomesingynecologicsurgeryaretrospectivecohortstudy AT appleannien prevalenceofhyperglycemiaanditsassociationwithperioperativeoutcomesingynecologicsurgeryaretrospectivecohortstudy AT zhaozhiguo prevalenceofhyperglycemiaanditsassociationwithperioperativeoutcomesingynecologicsurgeryaretrospectivecohortstudy AT sorabellalaural prevalenceofhyperglycemiaanditsassociationwithperioperativeoutcomesingynecologicsurgeryaretrospectivecohortstudy AT dumassusand prevalenceofhyperglycemiaanditsassociationwithperioperativeoutcomesingynecologicsurgeryaretrospectivecohortstudy AT adamronya prevalenceofhyperglycemiaanditsassociationwithperioperativeoutcomesingynecologicsurgeryaretrospectivecohortstudy AT prescottlaurens prevalenceofhyperglycemiaanditsassociationwithperioperativeoutcomesingynecologicsurgeryaretrospectivecohortstudy |