Perioperative Hyperglycemia and Postoperative Outcomes in Patients Undergoing Resection of Colorectal Liver Metastases.
There is limited evidence characterizing the impact of glycemic alterations on short-term outcomes among patients undergoing resection of colorectal liver metastases (CRLM).



Hyperglycemia was defined as a glucose value >125 mg/dl according to WHO definition. The impact of early postoperative hyperglycemia on short-term postoperative outcomes was assessed.



The mean postoperative glucose value was 128 mg/dl; 30 (9.8 %) patients had normal fasting glucose (<100 mg/dl), 106 patients had glucose intolerance (100-125 mg/dl), and 170 (55.5 %) patients had hyperglycemia (>125 mg/dl). A postoperative complication occurred in 101 patients (morbidity, 33.1 %); among patients who experienced a complication, an infectious complication was most common (38.6 %). After controlling for clinical factors, patients with hyperglycemia had an increased risk of overall complications [odds ratio (OR) 4.11; 95 % confidence interval (CI) 1.96-8.62, P < 0.001]. This was the case for both patients with and without diabetes (P < 0.05). Patients with hyperglycemia on the day of surgery were also at an increased risk of infections [OR 9.17; 95 % CI 2.26-37.13, P = 0.002] and had a longer hospital stay (normal glucose, 4 days vs. glucose 100-125 mg/dl, 4 days vs. glucose >125 mg/dl, 5 days, P < 0.001).



Early postoperative hyperglycemia was associated with adverse outcomes in patients with and without diabetes who underwent resection of CRLM. Perioperative glucose evaluation may be an important quality target.
Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Georgios Antonios
GA
Margonis
Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Neda
N
Amini
Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Kazunari
K
Sasaki
Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Yuhree
Y
Kim
Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Katiuscha
K
Merath
Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Stefan
S
Buettner
First Department of Surgery, Laiko Hospital, University of Athens, Athens, Greece.
Emmanouil
E
Pikoulis
Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Nikolaos
N
Andreatos
Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Doris
D
Wagner
Second Department of Propaedeutic Surgery, Laiko Hospital, University of Athens, Athens, Greece.
Efstathios
E
Antoniou
Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA. tim.pawlik@osumc.edu.|Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA. tim.pawlik@osumc.edu.
Timothy M
TM
Pawlik
D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D015179:Colorectal Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D003920:Diabetes Mellitus / Q000097:blood*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D006943:Hyperglycemia / Q000097:blood* / Q000150:complications; D008113:Liver Neoplasms / Q000097:blood / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D059035:Perioperative Period; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome
D001786:Blood Glucose
CRLM; Hyperglycemia; Short-term outcomes
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