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Intraoperative Hyperglycemia May Be Associated with an Increased Risk of Myocardial Injury after Non-Cardiac Surgery in Diabetic Patients

Background: Hyperglycemia in surgical candidates is associated with increased mortality and morbidity. We aimed to evaluate the effect of intraoperative blood glucose level on the incidence of myocardial injury after non-cardiac surgery (MINS) in diabetic patients. Methods: Diabetic patients with av...

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Autores principales: Kim, Sojin, Park, Jungchan, Kim, Hara, Yang, Kwangmo, Choi, Jin-ho, Kim, Kyunga, Sung, Jidong, Ahn, Joonghyun, Lee, Seung-Hwa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8623971/
https://www.ncbi.nlm.nih.gov/pubmed/34830501
http://dx.doi.org/10.3390/jcm10225219
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author Kim, Sojin
Park, Jungchan
Kim, Hara
Yang, Kwangmo
Choi, Jin-ho
Kim, Kyunga
Sung, Jidong
Ahn, Joonghyun
Lee, Seung-Hwa
author_facet Kim, Sojin
Park, Jungchan
Kim, Hara
Yang, Kwangmo
Choi, Jin-ho
Kim, Kyunga
Sung, Jidong
Ahn, Joonghyun
Lee, Seung-Hwa
author_sort Kim, Sojin
collection PubMed
description Background: Hyperglycemia in surgical candidates is associated with increased mortality and morbidity. We aimed to evaluate the effect of intraoperative blood glucose level on the incidence of myocardial injury after non-cardiac surgery (MINS) in diabetic patients. Methods: Diabetic patients with available intraoperative blood glucose measurement during non-cardiac surgery were enrolled in this study. Based on the highest intraoperative blood glucose level, patients were stratified into two groups: the blood sugar glucose (BST) < 180 group (intraoperative peak glucose < 180 mg/dL) and BST ≥ 180 group (intraoperative peak glucose ≥ 180 mg/dL). The primary outcome was the incidence of MINS, and secondary outcomes were in-hospital and 30-day mortalities. Results: Of the 11,302 diabetic patients, 8337 were in the BST < 180 group (73.8%) and 2965 in the BST ≥ 180 group (26.2%). After adjustment with inverse probability weighting, MINS was significantly higher in the BST ≥ 180 group (24.0% vs. 17.2%; odds ratio (OR), 1.26; 95% confidence interval (CI), 1.14–1.40; p < 0.001). In addition, in-hospital and 30-day mortalities were also higher in the BST ≥ 180 group compared to the BST < 180 group (4.2% vs. 2.3%, hazard ratio (HR), 1.39; 95% CI, 1.07–1.81; p = 0.001, and 3.1% vs. 1.8%; HR, 1.76; 95% CI, 1.31–2.36; p < 0.001, respectively). Receiver-operating characteristic plots showed that the threshold of glucose level associated with MINS was 149 mg/dL. Conclusion: Intraoperative hyperglycemia was associated with an increased MINS incidence and postoperative mortality in diabetic patients. Close monitoring of intraoperative blood glucose level may be helpful in detection and management of MINS.
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spelling pubmed-86239712021-11-27 Intraoperative Hyperglycemia May Be Associated with an Increased Risk of Myocardial Injury after Non-Cardiac Surgery in Diabetic Patients Kim, Sojin Park, Jungchan Kim, Hara Yang, Kwangmo Choi, Jin-ho Kim, Kyunga Sung, Jidong Ahn, Joonghyun Lee, Seung-Hwa J Clin Med Article Background: Hyperglycemia in surgical candidates is associated with increased mortality and morbidity. We aimed to evaluate the effect of intraoperative blood glucose level on the incidence of myocardial injury after non-cardiac surgery (MINS) in diabetic patients. Methods: Diabetic patients with available intraoperative blood glucose measurement during non-cardiac surgery were enrolled in this study. Based on the highest intraoperative blood glucose level, patients were stratified into two groups: the blood sugar glucose (BST) < 180 group (intraoperative peak glucose < 180 mg/dL) and BST ≥ 180 group (intraoperative peak glucose ≥ 180 mg/dL). The primary outcome was the incidence of MINS, and secondary outcomes were in-hospital and 30-day mortalities. Results: Of the 11,302 diabetic patients, 8337 were in the BST < 180 group (73.8%) and 2965 in the BST ≥ 180 group (26.2%). After adjustment with inverse probability weighting, MINS was significantly higher in the BST ≥ 180 group (24.0% vs. 17.2%; odds ratio (OR), 1.26; 95% confidence interval (CI), 1.14–1.40; p < 0.001). In addition, in-hospital and 30-day mortalities were also higher in the BST ≥ 180 group compared to the BST < 180 group (4.2% vs. 2.3%, hazard ratio (HR), 1.39; 95% CI, 1.07–1.81; p = 0.001, and 3.1% vs. 1.8%; HR, 1.76; 95% CI, 1.31–2.36; p < 0.001, respectively). Receiver-operating characteristic plots showed that the threshold of glucose level associated with MINS was 149 mg/dL. Conclusion: Intraoperative hyperglycemia was associated with an increased MINS incidence and postoperative mortality in diabetic patients. Close monitoring of intraoperative blood glucose level may be helpful in detection and management of MINS. MDPI 2021-11-09 /pmc/articles/PMC8623971/ /pubmed/34830501 http://dx.doi.org/10.3390/jcm10225219 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kim, Sojin
Park, Jungchan
Kim, Hara
Yang, Kwangmo
Choi, Jin-ho
Kim, Kyunga
Sung, Jidong
Ahn, Joonghyun
Lee, Seung-Hwa
Intraoperative Hyperglycemia May Be Associated with an Increased Risk of Myocardial Injury after Non-Cardiac Surgery in Diabetic Patients
title Intraoperative Hyperglycemia May Be Associated with an Increased Risk of Myocardial Injury after Non-Cardiac Surgery in Diabetic Patients
title_full Intraoperative Hyperglycemia May Be Associated with an Increased Risk of Myocardial Injury after Non-Cardiac Surgery in Diabetic Patients
title_fullStr Intraoperative Hyperglycemia May Be Associated with an Increased Risk of Myocardial Injury after Non-Cardiac Surgery in Diabetic Patients
title_full_unstemmed Intraoperative Hyperglycemia May Be Associated with an Increased Risk of Myocardial Injury after Non-Cardiac Surgery in Diabetic Patients
title_short Intraoperative Hyperglycemia May Be Associated with an Increased Risk of Myocardial Injury after Non-Cardiac Surgery in Diabetic Patients
title_sort intraoperative hyperglycemia may be associated with an increased risk of myocardial injury after non-cardiac surgery in diabetic patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8623971/
https://www.ncbi.nlm.nih.gov/pubmed/34830501
http://dx.doi.org/10.3390/jcm10225219
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