Kidney Cancer: High blood sugar before nephrectomy tied to longer hospital stay, study finds

China: Higher levels of pre-operative blood sugar levels in patients with renal cell carcinoma (RCC) undergoing laparoscopic nephrectomy are significantly associated with prolonged length of stay, a recent study has stated. The study appears in the journal Genitourinary Surgery - Frontiers.

A growing number of studies have found that pre-operative blood glucose (POBG) has adverse effects on patients undergoing surgery. Renal cell carcinoma (RCC) is a common malignancy of the urinary system originating from the kidney, accounting for 80-85% of renal malignancies, and its incidence has been increasing in recent years. 

Against the above background, Ting He, Department of Urology, Zhongda Hospital, Southeast University, Nanjing, China, and colleagues aimed to assess the effect of pre-operative blood glucose levels on the length of stay in patients with renal cell carcinoma undergoing laparoscopic nephrectomy.

The study used collected clinical data on 338 patients with RCC who had undergone laparoscopic nephrectomy between 2014 and 2019. Univariate and multivariate logistic regression and dose-response analysis curves of restricted cubic spline function were used to investigate the relationship between POBG and LOS.

According to the level of POBG, we divided the patients into three groups: <4.94 mmol/L group, 4.94 to <7.11 mmol/L group, and ≥7.11 mmol/L group.

The results of the study were found to be:

• According to the dose-response analysis curves, we found that the adjusted risk of LOS > 2 weeks and LOS > 3 weeks gradually increased with increasing POBG. In addition, they found that among all patients, patients with POBG levels ≥ 7.11 mmol/L had a 115% higher risk of LOS > 2 weeks than patients with POBG levels <4.94 mmol/L [adjusted odds risk (aOR) 2.15].

• Patients with POBG levels ≥ 7.11 mmol/L had a 129% higher risk of LOS > 3 weeks than patients with POBG levels <4.94 mmol/L (aOR 2.29). Moreover, similar results were observed in most subgroups analyses.

Dr. Ting He and his team concluded that "We found that in patients with RCC undergoing laparoscopic nephrectomy, higher POBG levels were significantly associated with prolonged LOS." They also stated that in addition, with the development of technology and the accumulation of surgical experience, the LOS in recent years is shorter than that in previous years, which is also a limitation of this study.

Reference:

The study titled, "Relationship Between Pre-operative Blood Glucose Level and Length of Hospital Stay in Patients With Renal Cell Carcinoma Undergoing Laparoscopic Nephrectomy," is published in the journal Genitourinary Surgery.

DOI: https://www.frontiersin.org/articles/10.3389/fsurg.2021.659365/full