Perioperative Hyperglycemia and Glucose Variability in Gynecologic Laparotomies

Abstract

Background: The glycemic response and its relation to postoperative complications following gynecologic laparotomies is unknown, although these surgeries carry a substantial risk for postoperative morbidity. Therefore, our objective was to assess the prevalence of perioperative hyperglycemia and glucose variability in women undergoing a gynecologic laparotomy. Methods: In this prospective cohort study, capillary glucose was measured every hour during the perioperative period. The primary outcome measures were the proportion of patients with postoperative hyperglycemia (glucose >180 mg d l-1) and the glucose variability in the intra- and postoperative period. Postoperative complications were assessed as secondary outcome measure. Results: We included 150 women undergoing a gynecologic laparotomy. Perioperative hyperglycemia occurred in 33 patients without diabetes (23.4%) and in 8 patients with diabetes (89%). Glucose variability was significantly higher (mean absolute glucose change [MAG] 11 mg dl-1 hr-1 [IQR 8-18]) in the intraoperative compared to the postoperative period (MAG 10 mg dl-1 hr-1 [IQR 3-16], P =.03). Neither hyperglycemia nor glucose variability was associated with postoperative complications. Conclusions: Hyperglycemia and glucose variability seem to be a minor problem during gynecologic laparotomy. Based on the current data, we would not advocate standardized glucose measurements in every patient without diabetes undergoing gynecologic laparotomy.