Impact of perioperative hyperglycemia in patients undergoing microvascular reconstruction.

Impact of perioperative hyperglycemia in patients undergoing microvascular reconstruction.

Head Neck. 2018 Mar 01;:

Authors: Bollig CA, Spradling CS, Dooley LM, Galloway TL, Jorgensen JB

Abstract
BACKGROUND: The effects of perioperative hyperglycemia on complications and outcomes in microvascular reconstruction have not been reported in the literature.
METHODS: A retrospective cohort of 203 patients undergoing microvascular reconstruction was generated. Perioperative glucose levels and clinical factors were tested for associations with complications using simple and multivariate analyses.
RESULTS: Hyperglycemia (blood glucose ≥ 180 mg/dL) occurred in 91 patients (44.8%) perioperatively, and was associated with increased rates of surgical complications, medical complications, surgical site infections, fistulas, and wound dehiscence. On univariate analysis, a more strict definition of hyperglycemia (blood glucose ≥ 165 mg/dL) was significantly associated with greater rates of venous thrombosis, although this lost statistical significance on multivariate analysis.
CONCLUSION: Perioperative hyperglycemia occurs commonly in patients undergoing microvascular reconstruction and is associated with higher rates of complications, independent of a preexisting diagnosis of diabetes mellitus. Further research is needed to define the ideal glycemic target in this population.

PMID: 29498137 [PubMed - as supplied by publisher]

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