title: Hyperglycemia 3 days after esophageal cancer surgery is associated with an increased risk of postoperative infection.
abstract: OBJECTIVE
  Postoperative hyperglycemia is associated with infectious complications after various types of surgery. Our objective was to determine whether postoperative blood glucose levels up to 1 week after highly invasive esophageal cancer surgery are associated with the incidence of postoperative infections (POIs).
  
  
  METHODS
  We conducted a retrospective chart review of 109 consecutive thoracic esophageal squamous cell cancer patients who underwent invasive esophagectomy with thoracotomy and laparotomy. The incidence of postoperative POIs and risk factors for POIs, including postoperative blood glucose levels, were evaluated.
  
  
  RESULTS
  Of the 109 patients, 37 (34.0 %) developed POIs. Clinically, 73.0 % of the POIs became evident on or after postoperative day 4 (median, 5.25 days; interquartile range, 3.00-9.25 days). On and after postoperative day 3, chronological changes in blood glucose levels were significantly different between two groups of patients with or without POIs, as indicated by repeated measures ANOVA (P = 0.006). Multivariate logistic regression analysis results showed that an increased blood glucose concentration on postoperative day 3 was a significant risk factor for POIs.
  
  
  CONCLUSIONS
  Our findings suggested that postoperative hyperglycemia on postoperative day 3 was a predictive factor of POIs after highly invasive esophageal cancer surgery.
authors.affiliation: Department of Surgery, Iwate Medical University, School of Medicine, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Ito
authors.forename: Takeshi
authors.initials: T
authors.lastname: Iwaya
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Ikeda
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kimura
authors.forename: Yuji
authors.initials: Y
authors.lastname: Akiyama
authors.forename: Masafumi
authors.initials: M
authors.lastname: Konosu
authors.forename: Kaoru
authors.initials: K
authors.lastname: Ishida
authors.forename: Hisataka
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Koki
authors.initials: K
authors.lastname: Otsuka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nitta
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kashiwaba
authors.forename: Keisuke
authors.initials: K
authors.lastname: Koeda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nishizuka
authors.forename: Masaru
authors.initials: M
authors.lastname: Mizuno
authors.forename: Akira
authors.initials: A
authors.lastname: Sasaki
authors.forename: Go
authors.initials: G
authors.lastname: Wakabayashi
mesh_terms: D000367:Age Factors; D001786:Blood Glucose / Q000378:metabolism*; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000209:etiology; D002764:Cholecystitis / Q000453:epidemiology / Q000382:microbiology; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000453:epidemiology* / Q000209:etiology; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology; D013908:Thoracotomy / Q000009:adverse effects; D013997:Time Factors
chemical_list: D001786:Blood Glucose