Postoperative hyperglycemia in patients undergoing cytoreductive surgery and HIPEC

A cohort study

Julie A. DiSano, Jonathan Wischhusen, Eric W. Schaefer, Sophie Dessureault, Joyce Wong, David Soybel, Colette R. Pameijer

Research output: Contribution to journalArticle

Abstract

Background: Hyperglycemia following elective or emergency surgery is generally associated with an increased risk of complications. The impact of hyperglycemia following surgery for peritoneal surface malignancy remains unclear. Materials and methods: Records of patients undergoing cytoreduction and HIPEC for peritoneal surface malignancy were reviewed at two institutions. Postoperative hyperglycemia was defined as serum glucose >140 mg/dl at the first measurement after surgery. Lengths of stay and 30-day complication rates were recorded. Results: There were 115 total patients included, 65 from Institution A (A) and 50 from Institution B (B). Perioperative steroids were given to 55% (A) and 100% (B) of patients, with postoperative hyperglycemia present in 39% and 86% of patients respectively. Complication rates were not significantly different in patients with hyperglycemia versus patients who were normoglycemic at each site [56% vs. 53%, p = 0.8 at (A); 47% vs. 43%, p = 1.0 at (B)]. Infection rates were also similar between groups [16% vs. 13%, p = 0.72 at (A); 14% vs. 29%, p = 0.31 at (B)]. Conclusions: Rates of hyperglycemia in patients undergoing cytoreduction and HIPEC are high. This likely represents a stress response but does not seem to have the same adverse impact as seen in other abdominal surgical patient populations.

Original languageEnglish (US)
Pages (from-to)5-9
Number of pages5
JournalInternational Journal of Surgery
Volume64
DOIs
StatePublished - Apr 1 2019

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Hyperglycemia
Cohort Studies
Length of Stay
Neoplasms
Emergencies
Steroids
Glucose
Infection
Serum
Population

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

DiSano, Julie A. ; Wischhusen, Jonathan ; Schaefer, Eric W. ; Dessureault, Sophie ; Wong, Joyce ; Soybel, David ; Pameijer, Colette R. / Postoperative hyperglycemia in patients undergoing cytoreductive surgery and HIPEC : A cohort study. In: International Journal of Surgery. 2019 ; Vol. 64. pp. 5-9.
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abstract = "Background: Hyperglycemia following elective or emergency surgery is generally associated with an increased risk of complications. The impact of hyperglycemia following surgery for peritoneal surface malignancy remains unclear. Materials and methods: Records of patients undergoing cytoreduction and HIPEC for peritoneal surface malignancy were reviewed at two institutions. Postoperative hyperglycemia was defined as serum glucose >140 mg/dl at the first measurement after surgery. Lengths of stay and 30-day complication rates were recorded. Results: There were 115 total patients included, 65 from Institution A (A) and 50 from Institution B (B). Perioperative steroids were given to 55{\%} (A) and 100{\%} (B) of patients, with postoperative hyperglycemia present in 39{\%} and 86{\%} of patients respectively. Complication rates were not significantly different in patients with hyperglycemia versus patients who were normoglycemic at each site [56{\%} vs. 53{\%}, p = 0.8 at (A); 47{\%} vs. 43{\%}, p = 1.0 at (B)]. Infection rates were also similar between groups [16{\%} vs. 13{\%}, p = 0.72 at (A); 14{\%} vs. 29{\%}, p = 0.31 at (B)]. Conclusions: Rates of hyperglycemia in patients undergoing cytoreduction and HIPEC are high. This likely represents a stress response but does not seem to have the same adverse impact as seen in other abdominal surgical patient populations.",
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Postoperative hyperglycemia in patients undergoing cytoreductive surgery and HIPEC : A cohort study. / DiSano, Julie A.; Wischhusen, Jonathan; Schaefer, Eric W.; Dessureault, Sophie; Wong, Joyce; Soybel, David; Pameijer, Colette R.

In: International Journal of Surgery, Vol. 64, 01.04.2019, p. 5-9.

Research output: Contribution to journalArticle

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T1 - Postoperative hyperglycemia in patients undergoing cytoreductive surgery and HIPEC

T2 - A cohort study

AU - DiSano, Julie A.

AU - Wischhusen, Jonathan

AU - Schaefer, Eric W.

AU - Dessureault, Sophie

AU - Wong, Joyce

AU - Soybel, David

AU - Pameijer, Colette R.

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N2 - Background: Hyperglycemia following elective or emergency surgery is generally associated with an increased risk of complications. The impact of hyperglycemia following surgery for peritoneal surface malignancy remains unclear. Materials and methods: Records of patients undergoing cytoreduction and HIPEC for peritoneal surface malignancy were reviewed at two institutions. Postoperative hyperglycemia was defined as serum glucose >140 mg/dl at the first measurement after surgery. Lengths of stay and 30-day complication rates were recorded. Results: There were 115 total patients included, 65 from Institution A (A) and 50 from Institution B (B). Perioperative steroids were given to 55% (A) and 100% (B) of patients, with postoperative hyperglycemia present in 39% and 86% of patients respectively. Complication rates were not significantly different in patients with hyperglycemia versus patients who were normoglycemic at each site [56% vs. 53%, p = 0.8 at (A); 47% vs. 43%, p = 1.0 at (B)]. Infection rates were also similar between groups [16% vs. 13%, p = 0.72 at (A); 14% vs. 29%, p = 0.31 at (B)]. Conclusions: Rates of hyperglycemia in patients undergoing cytoreduction and HIPEC are high. This likely represents a stress response but does not seem to have the same adverse impact as seen in other abdominal surgical patient populations.

AB - Background: Hyperglycemia following elective or emergency surgery is generally associated with an increased risk of complications. The impact of hyperglycemia following surgery for peritoneal surface malignancy remains unclear. Materials and methods: Records of patients undergoing cytoreduction and HIPEC for peritoneal surface malignancy were reviewed at two institutions. Postoperative hyperglycemia was defined as serum glucose >140 mg/dl at the first measurement after surgery. Lengths of stay and 30-day complication rates were recorded. Results: There were 115 total patients included, 65 from Institution A (A) and 50 from Institution B (B). Perioperative steroids were given to 55% (A) and 100% (B) of patients, with postoperative hyperglycemia present in 39% and 86% of patients respectively. Complication rates were not significantly different in patients with hyperglycemia versus patients who were normoglycemic at each site [56% vs. 53%, p = 0.8 at (A); 47% vs. 43%, p = 1.0 at (B)]. Infection rates were also similar between groups [16% vs. 13%, p = 0.72 at (A); 14% vs. 29%, p = 0.31 at (B)]. Conclusions: Rates of hyperglycemia in patients undergoing cytoreduction and HIPEC are high. This likely represents a stress response but does not seem to have the same adverse impact as seen in other abdominal surgical patient populations.

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