Glycemic profile and quality of recovery after emergency abdominal surgery - a prospective explorative cohort study

Publikation: Bidrag til tidsskriftTidsskriftartikelfagfællebedømt

Standard

Glycemic profile and quality of recovery after emergency abdominal surgery - a prospective explorative cohort study. / Clausen, Johan S R; Andersen, Jens R; Priergaard, Mie; Banke, Trine; Kristiansen, Puk; Hansen, Hannah F; Burcharth, Jakob; Gögenur, Ismail.

I: Acta Anaesthesiologica Scandinavica, Bind 67, Nr. 3, 2023, s. 302-310.

Publikation: Bidrag til tidsskriftTidsskriftartikelfagfællebedømt

Harvard

Clausen, JSR, Andersen, JR, Priergaard, M, Banke, T, Kristiansen, P, Hansen, HF, Burcharth, J & Gögenur, I 2023, 'Glycemic profile and quality of recovery after emergency abdominal surgery - a prospective explorative cohort study', Acta Anaesthesiologica Scandinavica, bind 67, nr. 3, s. 302-310. https://doi.org/10.1111/aas.14182

APA

Clausen, J. S. R., Andersen, J. R., Priergaard, M., Banke, T., Kristiansen, P., Hansen, H. F., Burcharth, J., & Gögenur, I. (2023). Glycemic profile and quality of recovery after emergency abdominal surgery - a prospective explorative cohort study. Acta Anaesthesiologica Scandinavica, 67(3), 302-310. https://doi.org/10.1111/aas.14182

Vancouver

Clausen JSR, Andersen JR, Priergaard M, Banke T, Kristiansen P, Hansen HF o.a. Glycemic profile and quality of recovery after emergency abdominal surgery - a prospective explorative cohort study. Acta Anaesthesiologica Scandinavica. 2023;67(3):302-310. https://doi.org/10.1111/aas.14182

Author

Clausen, Johan S R ; Andersen, Jens R ; Priergaard, Mie ; Banke, Trine ; Kristiansen, Puk ; Hansen, Hannah F ; Burcharth, Jakob ; Gögenur, Ismail. / Glycemic profile and quality of recovery after emergency abdominal surgery - a prospective explorative cohort study. I: Acta Anaesthesiologica Scandinavica. 2023 ; Bind 67, Nr. 3. s. 302-310.

Bibtex

@article{e1e72238096a4cb89734728ddf49f88f,
title = "Glycemic profile and quality of recovery after emergency abdominal surgery - a prospective explorative cohort study",
abstract = "BACKGROUND: Associations between degrees of postoperative hyperglycemia and morbidity has previously been established. There may be an association between the glycemic profile and patient-reported recovery, and this may be a target for perioperative quality improvements. We aimed to investigate the association between metrics of the 30-day glycemic profile and patient-reported recovery in non-diabetic patients after major abdominal surgery.METHODS: In a prospective, explorative cohort study, non-diabetic adult patients undergoing acute, major abdominal surgery were included within 24 hours after surgery. Interstitial fluid glucose concentration was measured for 30 consecutive days with a continuous glucose measurement device. The validated questionnaire 'Quality of Recovery-15' was used to assess patient-reported quality of recovery on postoperative days 10, 20, and 30. Follow-up time was divided into five-day postoperative intervals using days 26-30 as a reference. Linear mixed models were applied to investigate temporal changes in mean p-glucose, coefficient of variation, time within 70-140mg/dL, and time above 200mg/dL in relation to patient-reported recovery.RESULTS: Twenty-seven patients completed the study per protocol. A hyperglycemic event (>200 mg/dL) occurred in 18 of 27 patients (67%) within the first three postoperative days. Compared to the reference period, the coefficient of variation was significantly increased during all time intervals, indicating prolonged postoperative insulin resistance. During 30 days of follow-up, patient-reported recovery was associated with the coefficient of variation measured for three and five days before the corresponding recovery score assessment (recovery score estimate -1.52 [p<0.001] and -0.92 [p=0.006], respectively). We did not find an association between the remaining metrics and patient-reported recovery.CONCLUSION: Alterations in the glycemic profile are frequent and prolonged during the first postoperative month after major surgery probably due to peripheral insulin resistance. Our findings indicate that high glycemic variation is associated with poorer patient-reported recovery and might represent a proxy for care improvements in the postoperative period. This article is protected by copyright. All rights reserved.",
author = "Clausen, {Johan S R} and Andersen, {Jens R} and Mie Priergaard and Trine Banke and Puk Kristiansen and Hansen, {Hannah F} and Jakob Burcharth and Ismail G{\"o}genur",
note = "This article is protected by copyright. All rights reserved.",
year = "2023",
doi = "10.1111/aas.14182",
language = "English",
volume = "67",
pages = "302--310",
journal = "Acta Anaesthesiologica Scandinavica",
issn = "0001-5172",
publisher = "Wiley-Blackwell",
number = "3",

}

RIS

TY - JOUR

T1 - Glycemic profile and quality of recovery after emergency abdominal surgery - a prospective explorative cohort study

AU - Clausen, Johan S R

AU - Andersen, Jens R

AU - Priergaard, Mie

AU - Banke, Trine

AU - Kristiansen, Puk

AU - Hansen, Hannah F

AU - Burcharth, Jakob

AU - Gögenur, Ismail

N1 - This article is protected by copyright. All rights reserved.

PY - 2023

Y1 - 2023

N2 - BACKGROUND: Associations between degrees of postoperative hyperglycemia and morbidity has previously been established. There may be an association between the glycemic profile and patient-reported recovery, and this may be a target for perioperative quality improvements. We aimed to investigate the association between metrics of the 30-day glycemic profile and patient-reported recovery in non-diabetic patients after major abdominal surgery.METHODS: In a prospective, explorative cohort study, non-diabetic adult patients undergoing acute, major abdominal surgery were included within 24 hours after surgery. Interstitial fluid glucose concentration was measured for 30 consecutive days with a continuous glucose measurement device. The validated questionnaire 'Quality of Recovery-15' was used to assess patient-reported quality of recovery on postoperative days 10, 20, and 30. Follow-up time was divided into five-day postoperative intervals using days 26-30 as a reference. Linear mixed models were applied to investigate temporal changes in mean p-glucose, coefficient of variation, time within 70-140mg/dL, and time above 200mg/dL in relation to patient-reported recovery.RESULTS: Twenty-seven patients completed the study per protocol. A hyperglycemic event (>200 mg/dL) occurred in 18 of 27 patients (67%) within the first three postoperative days. Compared to the reference period, the coefficient of variation was significantly increased during all time intervals, indicating prolonged postoperative insulin resistance. During 30 days of follow-up, patient-reported recovery was associated with the coefficient of variation measured for three and five days before the corresponding recovery score assessment (recovery score estimate -1.52 [p<0.001] and -0.92 [p=0.006], respectively). We did not find an association between the remaining metrics and patient-reported recovery.CONCLUSION: Alterations in the glycemic profile are frequent and prolonged during the first postoperative month after major surgery probably due to peripheral insulin resistance. Our findings indicate that high glycemic variation is associated with poorer patient-reported recovery and might represent a proxy for care improvements in the postoperative period. This article is protected by copyright. All rights reserved.

AB - BACKGROUND: Associations between degrees of postoperative hyperglycemia and morbidity has previously been established. There may be an association between the glycemic profile and patient-reported recovery, and this may be a target for perioperative quality improvements. We aimed to investigate the association between metrics of the 30-day glycemic profile and patient-reported recovery in non-diabetic patients after major abdominal surgery.METHODS: In a prospective, explorative cohort study, non-diabetic adult patients undergoing acute, major abdominal surgery were included within 24 hours after surgery. Interstitial fluid glucose concentration was measured for 30 consecutive days with a continuous glucose measurement device. The validated questionnaire 'Quality of Recovery-15' was used to assess patient-reported quality of recovery on postoperative days 10, 20, and 30. Follow-up time was divided into five-day postoperative intervals using days 26-30 as a reference. Linear mixed models were applied to investigate temporal changes in mean p-glucose, coefficient of variation, time within 70-140mg/dL, and time above 200mg/dL in relation to patient-reported recovery.RESULTS: Twenty-seven patients completed the study per protocol. A hyperglycemic event (>200 mg/dL) occurred in 18 of 27 patients (67%) within the first three postoperative days. Compared to the reference period, the coefficient of variation was significantly increased during all time intervals, indicating prolonged postoperative insulin resistance. During 30 days of follow-up, patient-reported recovery was associated with the coefficient of variation measured for three and five days before the corresponding recovery score assessment (recovery score estimate -1.52 [p<0.001] and -0.92 [p=0.006], respectively). We did not find an association between the remaining metrics and patient-reported recovery.CONCLUSION: Alterations in the glycemic profile are frequent and prolonged during the first postoperative month after major surgery probably due to peripheral insulin resistance. Our findings indicate that high glycemic variation is associated with poorer patient-reported recovery and might represent a proxy for care improvements in the postoperative period. This article is protected by copyright. All rights reserved.

U2 - 10.1111/aas.14182

DO - 10.1111/aas.14182

M3 - Journal article

C2 - 36534071

VL - 67

SP - 302

EP - 310

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 3

ER -

ID: 330882545