Intraoperative Hyperglycemia May Be Associated with an Increased Risk of Myocardial Injury after Non-Cardiac Surgery in Diabetic Patients

Background: Hyperglycemia in surgical candidates is associated with increased mortality and morbidity. We aimed to evaluate the effect of intraoperative blood glucose level on the incidence of myocardial injury after non-cardiac surgery (MINS) in diabetic patients. Methods: Diabetic patients with av...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Sojin Kim, Jungchan Park, Hara Kim, Kwangmo Yang, Jin-ho Choi, Kyunga Kim, Jidong Sung, Joonghyun Ahn, Seung-Hwa Lee
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	non-cardiac surgery cardiac troponin hyperglycemia Medicine R
Acceso en línea:	https://doaj.org/article/85ffe0b0d1374c61a0b65f1856b436d6
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:85ffe0b0d1374c61a0b65f1856b436d6
record_format	dspace
spelling	oai:doaj.org-article:85ffe0b0d1374c61a0b65f1856b436d62021-11-25T18:00:35ZIntraoperative Hyperglycemia May Be Associated with an Increased Risk of Myocardial Injury after Non-Cardiac Surgery in Diabetic Patients10.3390/jcm102252192077-0383https://doaj.org/article/85ffe0b0d1374c61a0b65f1856b436d62021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/22/5219https://doaj.org/toc/2077-0383Background: Hyperglycemia in surgical candidates is associated with increased mortality and morbidity. We aimed to evaluate the effect of intraoperative blood glucose level on the incidence of myocardial injury after non-cardiac surgery (MINS) in diabetic patients. Methods: Diabetic patients with available intraoperative blood glucose measurement during non-cardiac surgery were enrolled in this study. Based on the highest intraoperative blood glucose level, patients were stratified into two groups: the blood sugar glucose (BST) < 180 group (intraoperative peak glucose < 180 mg/dL) and BST ≥ 180 group (intraoperative peak glucose ≥ 180 mg/dL). The primary outcome was the incidence of MINS, and secondary outcomes were in-hospital and 30-day mortalities. Results: Of the 11,302 diabetic patients, 8337 were in the BST < 180 group (73.8%) and 2965 in the BST ≥ 180 group (26.2%). After adjustment with inverse probability weighting, MINS was significantly higher in the BST ≥ 180 group (24.0% vs. 17.2%; odds ratio (OR), 1.26; 95% confidence interval (CI), 1.14–1.40; <i>p</i> < 0.001). In addition, in-hospital and 30-day mortalities were also higher in the BST ≥ 180 group compared to the BST < 180 group (4.2% vs. 2.3%, hazard ratio (HR), 1.39; 95% CI, 1.07–1.81; <i>p</i> = 0.001, and 3.1% vs. 1.8%; HR, 1.76; 95% CI, 1.31–2.36; <i>p</i> < 0.001, respectively). Receiver-operating characteristic plots showed that the threshold of glucose level associated with MINS was 149 mg/dL. Conclusion: Intraoperative hyperglycemia was associated with an increased MINS incidence and postoperative mortality in diabetic patients. Close monitoring of intraoperative blood glucose level may be helpful in detection and management of MINS.Sojin KimJungchan ParkHara KimKwangmo YangJin-ho ChoiKyunga KimJidong SungJoonghyun AhnSeung-Hwa LeeMDPI AGarticlenon-cardiac surgerycardiac troponinhyperglycemiaMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5219, p 5219 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	non-cardiac surgery cardiac troponin hyperglycemia Medicine R
spellingShingle	non-cardiac surgery cardiac troponin hyperglycemia Medicine R Sojin Kim Jungchan Park Hara Kim Kwangmo Yang Jin-ho Choi Kyunga Kim Jidong Sung Joonghyun Ahn Seung-Hwa Lee Intraoperative Hyperglycemia May Be Associated with an Increased Risk of Myocardial Injury after Non-Cardiac Surgery in Diabetic Patients
description	Background: Hyperglycemia in surgical candidates is associated with increased mortality and morbidity. We aimed to evaluate the effect of intraoperative blood glucose level on the incidence of myocardial injury after non-cardiac surgery (MINS) in diabetic patients. Methods: Diabetic patients with available intraoperative blood glucose measurement during non-cardiac surgery were enrolled in this study. Based on the highest intraoperative blood glucose level, patients were stratified into two groups: the blood sugar glucose (BST) < 180 group (intraoperative peak glucose < 180 mg/dL) and BST ≥ 180 group (intraoperative peak glucose ≥ 180 mg/dL). The primary outcome was the incidence of MINS, and secondary outcomes were in-hospital and 30-day mortalities. Results: Of the 11,302 diabetic patients, 8337 were in the BST < 180 group (73.8%) and 2965 in the BST ≥ 180 group (26.2%). After adjustment with inverse probability weighting, MINS was significantly higher in the BST ≥ 180 group (24.0% vs. 17.2%; odds ratio (OR), 1.26; 95% confidence interval (CI), 1.14–1.40; <i>p</i> < 0.001). In addition, in-hospital and 30-day mortalities were also higher in the BST ≥ 180 group compared to the BST < 180 group (4.2% vs. 2.3%, hazard ratio (HR), 1.39; 95% CI, 1.07–1.81; <i>p</i> = 0.001, and 3.1% vs. 1.8%; HR, 1.76; 95% CI, 1.31–2.36; <i>p</i> < 0.001, respectively). Receiver-operating characteristic plots showed that the threshold of glucose level associated with MINS was 149 mg/dL. Conclusion: Intraoperative hyperglycemia was associated with an increased MINS incidence and postoperative mortality in diabetic patients. Close monitoring of intraoperative blood glucose level may be helpful in detection and management of MINS.
format	article
author	Sojin Kim Jungchan Park Hara Kim Kwangmo Yang Jin-ho Choi Kyunga Kim Jidong Sung Joonghyun Ahn Seung-Hwa Lee
author_facet	Sojin Kim Jungchan Park Hara Kim Kwangmo Yang Jin-ho Choi Kyunga Kim Jidong Sung Joonghyun Ahn Seung-Hwa Lee
author_sort	Sojin Kim
title	Intraoperative Hyperglycemia May Be Associated with an Increased Risk of Myocardial Injury after Non-Cardiac Surgery in Diabetic Patients
title_short	Intraoperative Hyperglycemia May Be Associated with an Increased Risk of Myocardial Injury after Non-Cardiac Surgery in Diabetic Patients
title_full	Intraoperative Hyperglycemia May Be Associated with an Increased Risk of Myocardial Injury after Non-Cardiac Surgery in Diabetic Patients
title_fullStr	Intraoperative Hyperglycemia May Be Associated with an Increased Risk of Myocardial Injury after Non-Cardiac Surgery in Diabetic Patients
title_full_unstemmed	Intraoperative Hyperglycemia May Be Associated with an Increased Risk of Myocardial Injury after Non-Cardiac Surgery in Diabetic Patients
title_sort	intraoperative hyperglycemia may be associated with an increased risk of myocardial injury after non-cardiac surgery in diabetic patients
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/85ffe0b0d1374c61a0b65f1856b436d6
work_keys_str_mv	AT sojinkim intraoperativehyperglycemiamaybeassociatedwithanincreasedriskofmyocardialinjuryafternoncardiacsurgeryindiabeticpatients AT jungchanpark intraoperativehyperglycemiamaybeassociatedwithanincreasedriskofmyocardialinjuryafternoncardiacsurgeryindiabeticpatients AT harakim intraoperativehyperglycemiamaybeassociatedwithanincreasedriskofmyocardialinjuryafternoncardiacsurgeryindiabeticpatients AT kwangmoyang intraoperativehyperglycemiamaybeassociatedwithanincreasedriskofmyocardialinjuryafternoncardiacsurgeryindiabeticpatients AT jinhochoi intraoperativehyperglycemiamaybeassociatedwithanincreasedriskofmyocardialinjuryafternoncardiacsurgeryindiabeticpatients AT kyungakim intraoperativehyperglycemiamaybeassociatedwithanincreasedriskofmyocardialinjuryafternoncardiacsurgeryindiabeticpatients AT jidongsung intraoperativehyperglycemiamaybeassociatedwithanincreasedriskofmyocardialinjuryafternoncardiacsurgeryindiabeticpatients AT joonghyunahn intraoperativehyperglycemiamaybeassociatedwithanincreasedriskofmyocardialinjuryafternoncardiacsurgeryindiabeticpatients AT seunghwalee intraoperativehyperglycemiamaybeassociatedwithanincreasedriskofmyocardialinjuryafternoncardiacsurgeryindiabeticpatients
_version_	1718411756524535808

Intraoperative Hyperglycemia May Be Associated with an Increased Risk of Myocardial Injury after Non-Cardiac Surgery in Diabetic Patients

Ejemplares similares