Clinical significance of perioperative hyperglycemia in bariatric surgery: evidence for better perioperative glucose management

Meister, Katherine; Hufford, Theadore; Tu, Chao; Khorgami, Zhamak; Schauer, Philip R.; Brethauer, Stacy A.; Aminian, Ali

doi:10.1016/j.soard.2018.07.028

Cited by 25 publications

(22 citation statements)

References 22 publications

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“…In this previous study, the physician authors recommend closely examining the patients with risk factors that were individually significant such as smoking, cardiac dysrhythmias, or sleep apnea, or factors that were near significance and assess them in the context with overall comorbidities and other patient characteristics to determine if additional infection prevention may be appropriate for that patient. Previous literature has identified diabetes, obstructive sleep apnea, and a history of chronic obstructive pulmonary disease as risk factors for surgical site infections . Although not reaching statistical significance, both the prevalence of diabetes mellitus and peripheral vascular disease were higher in the individuals that had an infection in the reimplantation group.…”

Section: Discussionmentioning

confidence: 79%

Spinal Cord Stimulation Infection Rate and Incremental Annual Expenditures: Results From a United States Payer Database

Provenzano¹,

Falowski²,

Xia

et al. 2019

Neuromodulation: Technology at the Neural Interface

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Section: Discussionmentioning

confidence: 79%

Spinal Cord Stimulation Infection Rate and Incremental Annual Expenditures: Results From a United States Payer Database

Provenzano¹,

Falowski²,

Xia

et al. 2019

Neuromodulation: Technology at the Neural Interface

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“…Postoperative glucose levels have been studied in cardiac surgery, most notably, 4,[18][19][20] and more recently in non-cardiac surgery. [21][22][23] Patients with vascular disease often carry a diagnosis of diabetes, and the impact of glucose control upon outcomes following vascular surgery has not been well studied. We found that several adverse outcomes were associated with suboptimal glucose control irrespective of a diagnosis of diabetes.…”

Section: Discussionmentioning

confidence: 99%

Association of postoperative glycemic control with outcomes after carotid procedures

et al. 2019

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Objective There are limited data evaluating the impact of postoperative hyperglycemia in patients undergoing vascular procedures. This study evaluated the relationship between suboptimal glucose control and adverse outcomes after carotid artery stenting and carotid endarterectomy. Methods Patients admitted for elective carotid procedures were selected from the Cerner Health Facts® (2008–2015) database using ICD-9-CM diagnosis and procedure codes. We examined the relationship between patient characteristics, postoperative hyperglycemia (any value > 180 mg/dL), and complications with chi-square analysis. A multivariable model examined the association between patient characteristics, procedure type, and glucose control with infection, renal failure, stroke, respiratory and cardiac complications, and length of stay over 10 days. Results Of the 4287 patients admitted for an asymptomatic carotid procedure, 788 (18%) underwent carotid artery stenting and 3499 (82%) underwent carotid endarterectomy. Most patients (87%) had optimal postoperative glucose control (80–180 mg/dL); 13% had suboptimal glucose control. On average, patients with suboptimal glucose control experienced: higher stroke rates (6.2% vs. 2.7%; p < 0.001); more cardiac complications (5.1% vs. 2.0%; p < 0.001); longer hospital stays (3.1 vs. 1.8 days; p < .001); higher rates of post-procedure infection (4.0% vs. 1.8%; p = .001); and more complications than patients with optimal glucose control. Multivariable logistic regression demonstrated that patients with suboptimal glucose control had higher odds of having an infectious (pneumonia, cellulitis, surgical site, etc.) complication (OR 1.91, 95% CI 1.10–3.34), renal failure (OR 3.36, 95% CI 1.95–5.78), respiratory complications (OR 1.81, 95% CI 1.21–2.71), stroke (OR 1.82, 95% CI 1.15–2.88), or length of stay > 10 days (OR 4.07, 95% CI 2.02–8.20). Conclusions Suboptimal glucose control was associated with adverse events after carotid artery stenting and carotid endarterectomy, independent of a diabetes diagnosis. Several adverse outcomes were associated with hyperglycemia, including stroke. Given the singular role of carotid procedures in preventing stroke, we suggest that incorporating rigorous post-operative glucose control into best medical treatment of carotid disease should be considered as a standard practice.

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“…Perioperatif insülin direnci serbest yağ asitlerinde artışa neden olarak miyokardiyum için toksik etkilere, protein katabolizmasına ve yara iyileşmesinde gecikmeye yol açar (57,58) . Yapılan çalışmalarda, hiperglisemi ile yüzeyel yara yeri enfeksiyonları, ciddi enfeksiyonlar, hastanede kalış süresi ve geri kabul arasında doz yanıt ilişkisi de belirlenmiştir (59) . HbA1c düzeylerinin > %7 olmasının torasik ve lomber spinal enstrümantasyon cerrahisi için daha yüksek cerrahi alan enfeksiyon oranları ile ilişkili olduğu bulunmuştur (47) .…”

Section: Postoperatif Dönemunclassified

Peroperative Period with Diabetes Mellitus

Ceran¹,

Polat²

2020

jarss

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Diabetes mellitus en yaygın kronik hastalıklardan biridir. Ameliyat edilecek hastaların %25'i diabetes mellitus tanısı almış kişilerdir. Hiperglisemisi olan bireylerin peroperatif değerlendirilmesi hem anestezik yönetim hem de hastanın yaşam kalitesini belirleyecek önemdedir. Bu derlemede, diyabetin fizyopatolojisi, tanı kriterleri, farmakolojik ve peroperatif değerlendirilmesi ve yönetiminden söz edilmiştir.

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Clinical significance of perioperative hyperglycemia in bariatric surgery: evidence for better perioperative glucose management

Cited by 25 publications

References 22 publications

Spinal Cord Stimulation Infection Rate and Incremental Annual Expenditures: Results From a United States Payer Database

Spinal Cord Stimulation Infection Rate and Incremental Annual Expenditures: Results From a United States Payer Database

Association of postoperative glycemic control with outcomes after carotid procedures

Peroperative Period with Diabetes Mellitus

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