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Incidence and risk factors of intraoperative hyperglycemia in non-diabetic patients: a prospective observational study

BACKGROUND: Intraoperative hyperglycemia has been associated with multiple postoperative complications such as surgical site infection, myocardial infarction, stroke, and death. These complications are not confined to only diabetic patients. However, the incidence of intraoperative hyperglycemia in...

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Autores principales: Sermkasemsin, Varunya, Rungreungvanich, Mali, Apinyachon, Worapot, Sangasilpa, Inthuon, Srichot, Wanlee, Pisitsak, Chawika
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9463729/
https://www.ncbi.nlm.nih.gov/pubmed/36088294
http://dx.doi.org/10.1186/s12871-022-01829-9
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author Sermkasemsin, Varunya
Rungreungvanich, Mali
Apinyachon, Worapot
Sangasilpa, Inthuon
Srichot, Wanlee
Pisitsak, Chawika
author_facet Sermkasemsin, Varunya
Rungreungvanich, Mali
Apinyachon, Worapot
Sangasilpa, Inthuon
Srichot, Wanlee
Pisitsak, Chawika
author_sort Sermkasemsin, Varunya
collection PubMed
description BACKGROUND: Intraoperative hyperglycemia has been associated with multiple postoperative complications such as surgical site infection, myocardial infarction, stroke, and death. These complications are not confined to only diabetic patients. However, the incidence of intraoperative hyperglycemia in non-diabetic patients has not been fully elucidated. Additionally, these patients’ risk factors were not well established in previous studies. METHODS: Four hundred forty non-diabetic patients who underwent intermediate- to high-risk surgery were included in the study. We prospectively measured the capillary blood glucose level in all patients during surgery. The incidence of intraoperative hyperglycemia was defined as at least one episode of blood glucose level of more than 180 mg/dL. Risk factors for hyperglycemia were assessed using multivariable logistic regression analysis. RESULTS: Sixty-five (14.7%) patients developed hyperglycemia during surgery. The independent risk factors for intraoperative hyperglycemia were an American Society of Anesthesiologists status ≥ 3 (odds ratio [OR] 6.09, 95% confidence interval [CI]: 2.67–13.89, p < 0.001), preoperative impaired fasting blood sugar (OR 2.28, 95%CI:1.13–4.61, p = 0.021), duration of anesthesia ≥ 3 h (OR 4.06, 95%CI: 1.23–13.45, p = 0.021), intraoperative hypotension (OR 5.37, 95%CI: 2.35–12.29, p < 0.001), intraoperative blood transfusion (OR 4.35, 95%CI: 2.15–8.79, p < 0.001), and steroid use (OR 2.39, 95%CI: 1.20–4.76, p = 0.013). Surgical site infection was higher in patients with intraoperative hyperglycemia compared with patients without intraoperative hyperglycemia (4 [6.1%] vs. 6 [1.6%], respectively, p = 0.035). CONCLUSION: The incidence of intraoperative hyperglycemia was significant in non-diabetic patients during intermediate- to high-risk surgery. Risk factors should be identified to prevent intraoperative hyperglycemia. TRIAL REGISTRATION: The study was prospectively registered at https://www.thaiclinicaltrials.org (TCTR20191114001).
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spelling pubmed-94637292022-09-11 Incidence and risk factors of intraoperative hyperglycemia in non-diabetic patients: a prospective observational study Sermkasemsin, Varunya Rungreungvanich, Mali Apinyachon, Worapot Sangasilpa, Inthuon Srichot, Wanlee Pisitsak, Chawika BMC Anesthesiol Research BACKGROUND: Intraoperative hyperglycemia has been associated with multiple postoperative complications such as surgical site infection, myocardial infarction, stroke, and death. These complications are not confined to only diabetic patients. However, the incidence of intraoperative hyperglycemia in non-diabetic patients has not been fully elucidated. Additionally, these patients’ risk factors were not well established in previous studies. METHODS: Four hundred forty non-diabetic patients who underwent intermediate- to high-risk surgery were included in the study. We prospectively measured the capillary blood glucose level in all patients during surgery. The incidence of intraoperative hyperglycemia was defined as at least one episode of blood glucose level of more than 180 mg/dL. Risk factors for hyperglycemia were assessed using multivariable logistic regression analysis. RESULTS: Sixty-five (14.7%) patients developed hyperglycemia during surgery. The independent risk factors for intraoperative hyperglycemia were an American Society of Anesthesiologists status ≥ 3 (odds ratio [OR] 6.09, 95% confidence interval [CI]: 2.67–13.89, p < 0.001), preoperative impaired fasting blood sugar (OR 2.28, 95%CI:1.13–4.61, p = 0.021), duration of anesthesia ≥ 3 h (OR 4.06, 95%CI: 1.23–13.45, p = 0.021), intraoperative hypotension (OR 5.37, 95%CI: 2.35–12.29, p < 0.001), intraoperative blood transfusion (OR 4.35, 95%CI: 2.15–8.79, p < 0.001), and steroid use (OR 2.39, 95%CI: 1.20–4.76, p = 0.013). Surgical site infection was higher in patients with intraoperative hyperglycemia compared with patients without intraoperative hyperglycemia (4 [6.1%] vs. 6 [1.6%], respectively, p = 0.035). CONCLUSION: The incidence of intraoperative hyperglycemia was significant in non-diabetic patients during intermediate- to high-risk surgery. Risk factors should be identified to prevent intraoperative hyperglycemia. TRIAL REGISTRATION: The study was prospectively registered at https://www.thaiclinicaltrials.org (TCTR20191114001). BioMed Central 2022-09-10 /pmc/articles/PMC9463729/ /pubmed/36088294 http://dx.doi.org/10.1186/s12871-022-01829-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis 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
Sermkasemsin, Varunya
Rungreungvanich, Mali
Apinyachon, Worapot
Sangasilpa, Inthuon
Srichot, Wanlee
Pisitsak, Chawika
Incidence and risk factors of intraoperative hyperglycemia in non-diabetic patients: a prospective observational study
title Incidence and risk factors of intraoperative hyperglycemia in non-diabetic patients: a prospective observational study
title_full Incidence and risk factors of intraoperative hyperglycemia in non-diabetic patients: a prospective observational study
title_fullStr Incidence and risk factors of intraoperative hyperglycemia in non-diabetic patients: a prospective observational study
title_full_unstemmed Incidence and risk factors of intraoperative hyperglycemia in non-diabetic patients: a prospective observational study
title_short Incidence and risk factors of intraoperative hyperglycemia in non-diabetic patients: a prospective observational study
title_sort incidence and risk factors of intraoperative hyperglycemia in non-diabetic patients: a prospective observational study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9463729/
https://www.ncbi.nlm.nih.gov/pubmed/36088294
http://dx.doi.org/10.1186/s12871-022-01829-9
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