Pre-operative hyperglycemia may predict complications and recurrence following complex abdominal wall reconstruction

Written By : Dr. Shravani Dali |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-11-25T11:00:36+05:30 | Updated On 25 Nov 2023 12:21 PM IST

Pre-operative hyperglycemia is an important predictor of postoperative complications and recurrence following complex abdominal wall reconstruction suggests a new study published in the Plastic and Reconstructive Surgery.

The primary aim of this study was to determine whether preoperative hyperglycemia predicted surgical outcomes after complex abdominal wall reconstruction (CAWR). The secondary aim was to establish glucose thresholds to assist with surgical risk stratification.

All patients that underwent CAWR by the senior author at a single institution from 2002-2021 were retrospectively reviewed. Patients were stratified into four groups based on pre-operative blood glucose: <100 mg/dl (n=184), 100-140 mg/dl (n=207), 140-180 mg/dl (n=41), and > 180 mg/dl (n=16). Patient demographics, risk factors, surgical techniques, complications, and outcomes were recorded and compared.

RESULTS:

The study cohort was comprised of 478 patients. Mean age was 53.9 ± 12.3 years. Mean body mass index (BMI) was 32.1 ± 7.8. Higher age (p=0.0085), higher BMI (p=0.0005), the presence of diabetes (<0.0001), and hypertension (0.0004) were significantly associated with higher glucose. Overall complication rates ranged from 26% (glucose <100mg/dL) to 94% (glucose >180 mg/dL) while recurrence rates ranged from 10% (glucose <100 mg/dL) to 37% (glucose 140-180 mg/dL). Multivariate logistic regression analysis revealed pre-operative glucose to have a significant, independent effect on overall complication rate (p<0.0001), major complication rate (p<0.0001), and recurrence rate (p<0.0031).

Pre-operative hyperglycemia is an important predictor of post-operative complications and recurrence following CAWR. Point of care glucose levels are routinely gathered prior to surgery and may help to establish thresholds for which elective CAWR might be deferred. Strategies to lower pre-operative glucose should be part of an optimization protocol for improving outcomes.

Reference:

Marxen, Troy BS; Su, Shannon BS; Brown, Ciara MD; Faulkner, Heather MD MPH; Losken, Albert MD. 38. Pre-operative Glucose Predicts Post-operative Complications following Complex Abdominal Wall Reconstruction. Plastic and Reconstructive Surgery - Global Open 11(4S):p 19, April 2023. | DOI: 10.1097/01.GOX.0000934272.26490.6d

Keywords:

Plastic and Reconstructive Surgery, Marxen, Troy BS; Su, Shannon BS; Brown, Ciara MD; Faulkner, Heather MD MPH; Losken, Albert, Pre-operative, Glucose, Predicts Post-operative, Complications, following, Complex Abdominal Wall Reconstruction

Plastic and Reconstructive SurgeryPre-operativeGlucosePredicts Post-operativeComplicationsfollowingComplex Abdominal Wall Reconstruction

Source : Plastic and Reconstructive Surgery

Dr. Shravani Dali

Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751