Early post-operative glucose levels are an independent risk factor for infection after peripheral vascular surgery. A retrospective study.
OBJECTIVE
To evaluate whether hyperglycaemia in the first 48 h after infrainguinal vascular surgery is a risk factor for post-operative infection, independent from factors associated with insulin resistance and surgical stress.


METHODS
Retrospective cohort study.


METHODS
Patients who underwent infrainguinal vascular surgery in our hospital between March 1998 and March 2003 were included. Glucose values until 48 h after surgery were retrieved from laboratory reports. Post-operative infections, treated with antibiotics, during hospital stay were scored until 30 days after surgery. Data were analysed with univariate and multivariate logistic regression analyses.


RESULTS
At least one post-operative glucose value was retrieved for 211/275 (77%) patients. The incidence of post-operative infections was 84/275 (31%). When corrected for factors associated with insulin resistance and surgical stress, post-operative glucose levels were found to be an independent risk factor for post-operative infections (odds ratio top quartile versus lowest quartile: 5.1; 95% confidence interval: 1.6-17.1; P=0.007).


CONCLUSIONS
Post-operative glucose levels appear to be an independent risk factor for infections after infrainguinal vascular surgery. This finding requires confirmation in a prospective study.
Department of Internal Medicine, Academic Medical Centre, Amsterdam, The Netherlands. t.m.vriesendorp@amc.uva.nl
T M
TM
Vriesendorp
Q J
QJ
Morélis
J H
JH
Devries
D A
DA
Legemate
J B L
JB
Hoekstra
D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology*; D035002:Lower Extremity / Q000098:blood supply / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology*; D013997:Time Factors; D014656:Vascular Surgical Procedures / Q000009:adverse effects*
D001786:Blood Glucose