Immediate postoperative hyperglycemia after peripheral arterial bypass is associated with short-term and long-term poor outcomes

Kronfli, Anthony; Boukerche, Faiza; Medina, Daniela; Geertsen, Alex; Patel, Akshil; Ramedani, Shayann; Lehman, Erik; Aziz, Faisal

doi:10.1016/j.jvs.2020.08.126

Cited by 8 publications

(4 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Diabetic patients had lower prevalence of PVD due to age differences in both groups. The prevalence of PVD in the non-diabetic group may be underestimated since the population was smaller and the review rate was lower than in diabetics [21,22]. However, because urine testing was the primary technique of screening for diabetes, It is widely considered that diabetic patients are more prone to illness below the, however the current survey found no evidence of this.…”

Section: Discussionmentioning

confidence: 56%

Comparison of Angiographic Characteristics of Peripheral Arterial Disease between Diabetic and Non-Diabetics

Ullah¹,

Ullah²,

Ahmad³

et al. 2022

PJMHS

View full text Add to dashboard Cite

Background and Aim: Several factors contribute to the poor outcomes of peripheral arterial disease (PAD). The current study examined the results of peripheral transluminal angioplasty (PTA) in diabetics and non-diabetics with peripheral arterial disease (PAD). Patients and Methods: This cross-sectional study was carried out on 136 peripheral arteries disease patients including 84 non-diabetic and 52 diabetics in the department of Cardiology, Hayatabad Medical Complex, Peshawar during the period from January 2022 to June 2022. This study included patients with PADs who had PTAs performed on their femoral, iliac, infrapopliteal, and popliteal arteries. Study protocol was approved by the research and ethical committee. Patient’s demographic details and medical history were recorded. SPSS version 26 was used for data analysis. Results: The overall mean age was 64.6 ± 10.51 years. Diabetic patients were compared with non-diabetic patients in terms of age (63.8±11.2 versus 65.4± 9.82 years), smoking history (80.7% vs. 46.4%), hypercholesterolemia (25.4% versus 31.9%), and ischemic heart disease (40.6% versus 36.5%). The frequency of hypertensive patients was higher 64.8% in diabetic patients against 40.6% in non-diabetic patients. In terms of arterial segment below the knee and profunda femoris, arterial disease had higher severity in diabetic patients. Diabetic patients were more susceptible to amputation (43.2% vs. 12%, OR=4.8, P=0.001) and had higher mortality (48.9% versus 23.8%). Conclusion: The present study found that higher prevalence of limb ischemia, amputation, and higher rates of restenosis following peripheral transluminal angioplasty was found in diabetic patients compared to non-diabetic patients. Diabetic patients had poor prognosis and worse arterial disease than non-diabetic patients. Keywords: Diabetic patients, Angiographic characteristics, Peripheral arteries disease.

show abstract

Section: Discussionmentioning

confidence: 56%

Comparison of Angiographic Characteristics of Peripheral Arterial Disease between Diabetic and Non-Diabetics

Ullah¹,

Ullah²,

Ahmad³

et al. 2022

PJMHS

View full text Add to dashboard Cite

show abstract

“…They showed that this situation is also associated with poor long-term outcomes. 11 Surgery undoubtedly creates a situation of stress for the body and in their study; it was revealed that the risk of amputation increased according to the hyperglycemia response to surgical stress in patients. In our study, similarly, the hyperglycemia response of the body to acute extremity ischemia was significantly higher in patients who developed amputation.…”

Section: Discussionmentioning

confidence: 99%

Investigation of the effect of acute to chronic glycemic ratio on major amputation development after surgical thromboembolectomy in patients with acute lower extremity ischemia

et al. 2022

View full text Add to dashboard Cite

Background Acute limb ischemia (ALI) is an emergency vascular pathology in which perfusion is disrupted in the lower extremity and threatens extremity viability. The admission blood glucose (ABG)/estimated average glucose (eAG) value has recently been shown as a prognostic marker in acute cardiovascular events. In this study, we aimed to investigate the predictive role of an ABG/eAG value in predicting development of early postoperative major amputation after emergency thromboembolectomy operations in patients presenting with ALI. Method Patients who admitted to our hospital with ALI between November 01, 2016 and September 01, 2021 and underwent surgical thromboembolectomy were retrospectively included in the study. Patients who did not undergo postoperative limb amputation were recorded as Group 1, and patients who underwent major amputation in the early postoperative period (in-hospital), were recorded as Group 2. Results The median age of the 226 patients included in Group 1 and 72 patients in Group 2 were 58 (34–86) years and 69 (33–91) years, respectively ( p<0.001). In univariate analysis, in-hospital amputation was found to significantly correlate with age>70 years (odds ratio [OR]: 1.914, 95% confidence interval [CI]: 1.351–2.319, p<0.001), PAD (OR: 1.698, 95% CI: 1.270–1.992, p = 0.002 re-embolectomy (OR: 2.184, 95% CI: 1.663–3.085, p < 0.001), admission Rutherford class (OR: 0.762, 95% CI: 0.591–0.859, p = 0.032), admission time>6 h (OR: 1.770, 95% CI: 1.480–1.152, p = 0.009), ABG (OR: 1.275, 95% CI: 1.050–1.790, p < 0.001), and ABG/eAG (OR: 1.669, 95% CI: 1.315–2.239, p < 0.001). Conclusion According to our study, we can predict patient groups with a high risk of major amputation with the ABG/eAG value calculated from the blood values of the patients at the time of admission.

show abstract

“…Early postoperative hyperglycemia is associated with adverse clinical outcomes including increases in postoperative complications (6,(10)(11)(12)(13), length of hospital stay (6,11), medical expenses (11,13), and perioperative mortality (6,7,9). As a matter of fact, persistent postoperative hyperglycemia has been reported to be a useful predictor of complications that require readmission and reoperation (7,14).…”

Section: Introductionmentioning

confidence: 99%

“…Evidence regarding the impact of postoperative hyperglycemia on long-term outcomes is limited. In a retrospective study of 505 patients following peripheral arterial bypass surgery, immediate postoperative hyperglycemia (≥7.8 mmol/L) was associated with an increased risk of long-term amputations ( 13 ). In another retrospective study, 104 patients were included in the analysis after propensity score matching; those with postoperative hyperglycemia (≥ 7.8 mmol/L) had worse long-term survival after gastric cancer surgery ( 21 ).…”

Section: Introductionmentioning

confidence: 99%

Hyperglycemia is associated with worse 3-year survival in older patients admitted to the intensive care unit after non-cardiac surgery: Post hoc analysis of a randomized trial

Deng²,

Su³

et al. 2022

Front. Med.

View full text Add to dashboard Cite

ObjectiveHyperglycemia is common in critically ill patients after surgery and is associated with worse perioperative outcomes. Yet, the impact of postoperative hyperglycemia on long-term outcomes remains unclear. We therefore analyzed the association between early postoperative hyperglycemia and 3-year overall survival in older patients who were admitted to the intensive care unit after surgery.MethodsThis was a post hoc analysis of database obtained from a previous randomized trial and 3-year follow-up. The underlying trial enrolled 700 patients aged 65 years or older who were admitted to the intensive care unit after elective non-cardiac surgery. Early postoperative time-weighted average blood glucose was calculated and was divided into three levels, i.e., <8.0 mmol/L, from 8.0 to 10.0 mmol/L, and >10.0 mmol/L. The primary outcome was 3-year overall survival. The association between time-weighted average blood glucose level and 3-year overall survival was analyzed with Cox proportional hazard regression models. Subgroup analyses were also performed in patients with or without diabetes, and in patients following cancer or non-cancer surgery.ResultsA total of 677 patients (mean age 74 years, 60% male sex) were included in the final analysis. Within 3 years after surgery, deaths occurred in 22.1% (30/136) of patients with time-weighted average blood glucose <8.0 mmol/L, compared with 35.7% (81/227) of those from 8.0 to 10.0 mmol/L (unadjusted hazard ratio 1.75, 95% CI 1.15 to 2.67, P = 0.009), and 36.9% (116/314) of those >10.0 mmol/L (unadjusted hazard ratio 1.91, 95% CI 1.28 to 2.85, P = 0.002). After adjustment for confounding factors, the risk of 3-year mortality remained higher in patients with time-weighted average blood glucose from 8.0 to 10.0 mmol/L (adjusted hazard ratio 2.28, 95% CI 1.47 to 3.54, P < 0.001) and in those >10.0 mmol/L (adjusted hazard ratio 2.00, 95% CI 1.29 to 3.10, P = 0.002). Similar results were obtained in the subgroups of patients without diabetes and patients following cancer surgery.ConclusionFor older patients admitted to the intensive care unit after elective non-cardiac surgery, high early blood glucose (time-weighted average blood glucose ≥ 8.0 mmol/L) was associated with poor 3-year overall survival. The impact of moderate glycemic control on long-term survival deserves further investigation.

show abstract

Immediate postoperative hyperglycemia after peripheral arterial bypass is associated with short-term and long-term poor outcomes

Cited by 8 publications

References 28 publications

Comparison of Angiographic Characteristics of Peripheral Arterial Disease between Diabetic and Non-Diabetics

Comparison of Angiographic Characteristics of Peripheral Arterial Disease between Diabetic and Non-Diabetics

Investigation of the effect of acute to chronic glycemic ratio on major amputation development after surgical thromboembolectomy in patients with acute lower extremity ischemia

Hyperglycemia is associated with worse 3-year survival in older patients admitted to the intensive care unit after non-cardiac surgery: Post hoc analysis of a randomized trial

Contact Info

Product

Resources

About