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J Diabetes Complications. 2018 Mar;32(3):305-309. doi: 10.1016/j.jdiacomp.2017.11.010. Epub 2017 Nov 29.

Stress hyperglycemia in general surgery: Why should we care?

Author information

1
Department of Medicine, Emory University, Atlanta, GA, United States.
2
Rollins School of Public Health, Emory University, Atlanta, GA, United States.
3
Department of Medicine, Emory University, Atlanta, GA, United States. Electronic address: geumpie@emory.edu.

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) <140mg/dL] who developed stress hyperglycemia (BG >140mg/dL or >180mg/dL) within 48h 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 180mg/dL and 206 patients (10.5%) had BG>180mg/dL. The median length of hospital stay (LOS) was 9days [interquartile range (IQR) 5,15] for BG between 140 and 180mg/dL and 12days (IQR 6,18) for BG>180mg/dL compared to normoglycemia at 6days (IQR 4,11), both p<0.001. Patients with BG 140-180mg/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>180mg/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.

KEYWORDS:

General surgery; Hospital complications; Hospital hyperglycemia; Hospital mortality; Inpatient hyperglycemia; Stress hyperglycemia

PMID:
29273446
PMCID:
PMC5975368
[Available on 2019-03-01]
DOI:
10.1016/j.jdiacomp.2017.11.010

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