About this item:

52 Views | 9 Downloads

Author Notes:

Corresponding author at: Diabetes and Endocrinology Section, Grady Health System, 69 Jesse Hill Jr. Dr. SE, Atlanta, GA 30303, United States. geumpie@emory.edu (G.E. Umpierrez).

Contributed equal effort: GD and MF

GEU is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

GD, MF and GEU wrote the initial research proposal.

GD, MF, SH and GEU wrote the manuscript.

DRU, FJP, JSH, PV, and SJ reviewed/edited the research proposal and manuscript and contributed to the discussion.

LP conducted the statistical analysis.

GD, MF, DRU, SH, JSH, LP, and SJ declared no conflicts of interest.

Subjects:

Research Funding:

The present study was supported by an unrestricted grant from the Jacobs Family Research Fund (to Emory University and GEU).

GEU is partly supported by research grants from the Public Health Service (grants UL1 TR002378 from the Clinical and Translational Science Award program and 1P30DK111024-01 from the National Institutes of Health and National Center for Research Resources).

GEU has received unrestricted research support for inpatient studies (to Emory University) from Merck, Novo Nordisk, AstraZeneca, Boehringer Ingelheim, and Sanofi.

FJP and PV have received consulting fees from Boehringer Ingelheim and Merck.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Endocrinology & Metabolism
  • Inpatient hyperglycemia
  • General surgery
  • Stress hyperglycemia
  • Hospital hyperglycemia
  • Hospital mortality
  • Hospital complications
  • CRITICALLY-ILL PATIENTS
  • INPATIENT GLYCEMIC CONTROL
  • IN-HOSPITAL MORTALITY
  • BYPASS GRAFT-SURGERY
  • OXIDATIVE STRESS
  • GLUCOSE CONTROL
  • ASSOCIATION
  • MORBIDITY
  • IMPACT

Stress hyperglycemia in general surgery: Why should we care?

Tools:

Journal Title:

Journal of Diabetes and its Complications

Volume:

Volume 32, Number 3

Publisher:

, Pages 305-309

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Aims: To determine the frequency of increasing levels of stress hyperglycemia and its associated complications in surgery patients without a history of diabetes. Methods: We reviewed hospital outcomes in 1971 general surgery patients with documented preoperative normoglycemia [blood glucose (BG) < 140 mg/dL] who developed stress hyperglycemia (BG > 140 mg/dL or > 180 mg/dL) within 48 h after surgery between 1/1/2010 and 10/31/2015. Results: A total of 415 patients (21%) had ≥ 1 episode of BG between 140 and 180 mg/dL and 206 patients (10.5%) had BG > 180 mg/dL. The median length of hospital stay (LOS) was 9 days [interquartile range (IQR) 5,15] for BG between 140 and 180 mg/dL and 12 days (IQR 6,18) for BG > 180 mg/dL compared to normoglycemia at 6 days (IQR 4,11), both p < 0.001. Patients with BG 140–180 mg/dL had higher rates of complications with an odds ratio (OR) of 1.68 [95% confidence interval (95% CI) 1.15–2.44], and those with BG > 180 mg/dL had more complications [OR 3.46 (95% CI 2.24–5.36)] and higher mortality [OR 6.56 (95% CI 2.12–20.27)] compared to normoglycemia. Conclusion: Increasing levels of stress hyperglycemia are associated with higher rates of perioperative complications and hospital mortality in surgical patients without diabetes.

Copyright information:

© 2017

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Creative Commons License

Export to EndNote