Impact of perioperative hyperglycemia in patients undergoing microvascular reconstruction

BackgroundThe effects of perioperative hyperglycemia on complications and outcomes in microvascular reconstruction have not been reported in the literature. MethodsA retrospective cohort of 203 patients undergoing microvascular reconstruction was generated. Perioperative glucose levels and clinical factors were tested for associations with complications using simple and multivariate analyses. ResultsHyperglycemia (blood glucose180mg/dL) occurred in 91 patients (44.8%) perioperatively, and was associated with increased rates of surgical complications, medical complications, surgical site infections, fistulas, and wound dehiscence. On univariate analysis, a more strict definition of hyperglycemia (blood glucose165mg/dL) was significantly associated with greater rates of venous thrombosis, although this lost statistical significance on multivariate analysis. ConclusionPerioperative hyperglycemia occurs commonly in patients undergoing microvascular reconstruction and is associated with higher rates of complications, independent of a preexisting diagnosis of diabetes mellitus. Further research is needed to define the ideal glycemic target in this population.