Incidence and risk factors of intraoperative hyperglycemia in non-diabetic patients: a prospective observational study
Issued Date
2022-12-01
Resource Type
eISSN
14712253
Scopus ID
2-s2.0-85138127842
Pubmed ID
36088294
Journal Title
BMC Anesthesiology
Volume
22
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
BMC Anesthesiology Vol.22 No.1 (2022)
Suggested Citation
Sermkasemsin V., Rungreungvanich M., Apinyachon W., Sangasilpa I., Srichot W., Pisitsak C. Incidence and risk factors of intraoperative hyperglycemia in non-diabetic patients: a prospective observational study. BMC Anesthesiology Vol.22 No.1 (2022). doi:10.1186/s12871-022-01829-9 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/87176
Title
Incidence and risk factors of intraoperative hyperglycemia in non-diabetic patients: a prospective observational study
Author's Affiliation
Other Contributor(s)
Abstract
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).