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Glucose Predicts Mortality in Surgical Patients

Diabetes Care; ePub 2018 Feb 13; van den Boom, et al

Perioperative glucose appears to predict 30-day mortality in people who have had cardiac or noncardiac surgery, according to a retrospective analysis involving >13,000 individuals. The link is nonlinear in the cardiac group, and linear in the noncardiac contingent. Participants had either cardiac (n=6,393) or noncardiac (n=6,684) surgery at the Duke University Health System. Investigators looked for the link between preoperative A1C and 1) perioperative glucose (averaged over the first 3 postoperative days) and 2) 30-day mortality. Among the results:

  • A1C and glucose were strongly linked.
  • Glucose and mortality were positively linked in those who had noncardiac surgery.
  • In these patients, mortality was 1% when glucose averaged 100 mg/dL and 1.6% when it averaged 200 mg/dL.
  • For cardiac procedures, mortality averaged 4.5% at 100 mg/dL, 1.5% at 140 mg/dL, and 6.9% at 200 mg/dL.
  • A1C and 30-day mortality were not linked after controlling for glucose in both groups.
Citation:

van den Boom W, Schroeder R, Manning M, Setji T, Fiestanand G, Dunson D. Effect of A1C and glucose on postoperative mortality in noncardiac and cardiac surgeries. [Published online ahead of print February 13, 2018]. Diabetes Care. doi:10.2337/dc17-2232.

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