Impact of Postoperative Glycemic Control on Postoperative Morbidity in Patients Undergoing Open Pancreaticoduodenectomy
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved..
OBJECTIVE: To evaluate the impact of postoperative glycemic control on postoperative morbidity in patients undergoing a pancreaticoduodenectomy.
METHODS: A retrospective study was performed on patients at The Johns Hopkins Hospital between April 2015 and April 2016. Data were collected on postoperative insulin regimens, blood glucose, rates of hyperglycemia and hypoglycemia, and postoperative complications and were evaluated.
RESULTS: Out of 244 patients, 114 (46.7%) experienced at least 1 hyperglycemic (>180 mg/dL) episode and 16 (6.6%) experienced at least 1 hypoglycemic episode (<70 mg/dL) during the first postoperative 24 hours. Early postoperative hyperglycemia (>180 mg/dL) was associated with a significantly higher rate of surgical site infections (15.7% vs 7%; P = 0.031). Late postoperative hyperglycemia (>180 mg/dL) was associated with a significantly higher rate of fistulas (4.3% vs 14.6%; P = 0.021).
CONCLUSIONS: Early hyperglycemia (>180 mg/dL) is associated with a higher risk of surgical site infections while late hyperglycemia is associated with a higher risk of fistulas. Intensive glucose control (<150 mg/dL) was not demonstrated to decrease the risk of postoperative complications. Similar to other critically ill populations, targeting a glucose goal of <180 mg/dL may be an appropriate target to reduce morbidity without increasing the risk of hypoglycemia.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:50 |
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| Enthalten in: |
Pancreas - 50(2021), 6 vom: 01. Juli, Seite 834-840 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Yun, Regina [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 07.02.2022 Date Revised 22.08.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1097/MPA.0000000000001856 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM328921319 |
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| 500 | |a Date Revised 22.08.2023 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. | ||
| 520 | |a OBJECTIVE: To evaluate the impact of postoperative glycemic control on postoperative morbidity in patients undergoing a pancreaticoduodenectomy | ||
| 520 | |a METHODS: A retrospective study was performed on patients at The Johns Hopkins Hospital between April 2015 and April 2016. Data were collected on postoperative insulin regimens, blood glucose, rates of hyperglycemia and hypoglycemia, and postoperative complications and were evaluated | ||
| 520 | |a RESULTS: Out of 244 patients, 114 (46.7%) experienced at least 1 hyperglycemic (>180 mg/dL) episode and 16 (6.6%) experienced at least 1 hypoglycemic episode (<70 mg/dL) during the first postoperative 24 hours. Early postoperative hyperglycemia (>180 mg/dL) was associated with a significantly higher rate of surgical site infections (15.7% vs 7%; P = 0.031). Late postoperative hyperglycemia (>180 mg/dL) was associated with a significantly higher rate of fistulas (4.3% vs 14.6%; P = 0.021) | ||
| 520 | |a CONCLUSIONS: Early hyperglycemia (>180 mg/dL) is associated with a higher risk of surgical site infections while late hyperglycemia is associated with a higher risk of fistulas. Intensive glucose control (<150 mg/dL) was not demonstrated to decrease the risk of postoperative complications. Similar to other critically ill populations, targeting a glucose goal of <180 mg/dL may be an appropriate target to reduce morbidity without increasing the risk of hypoglycemia | ||
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| 700 | 1 | |a Jarrell, Andrew S |e verfasserin |4 aut | |
| 700 | 1 | |a Crow, Jessica |e verfasserin |4 aut | |
| 700 | 1 | |a Wright, Michael J |e verfasserin |4 aut | |
| 700 | 1 | |a Burkhart, Richard A |e verfasserin |4 aut | |
| 700 | 1 | |a Rybny, Joseph |e verfasserin |4 aut | |
| 700 | 1 | |a Wolfgang, Christopher L |e verfasserin |4 aut | |
| 700 | 1 | |a Kruer, Rachel M |e verfasserin |4 aut | |
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