EP427 - Glycemic variability increases the risk of postoperative complications following colorectal cancer surgery

ePoster Presenter(s)

• HB

  Hyeon Woo Bae, n/a

  Fellow
  Severance Hospital
  Seoul, Seoul-t'ukpyolsi, Republic of Korea

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

  View ePoster

Author(s)

• 

  Min Young Park

  Clinical assistant professor
  Severance Hospital
  Mapo-gu, Seoul-t'ukpyolsi, Republic of Korea

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.
• SY

  Seung Yoon Yang, n/a

  Clinical assistant professor
  Severance Hospital
  Seoul, Seoul-t'ukpyolsi, Republic of Korea

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.
• YH

  Yoon Dae Han, n/a

  Facalty
  Severance Hospital
  Seoul, Seoul-t'ukpyolsi, Republic of Korea

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.
• MC

  Min Soo Cho, n/a

  Assistant Professor
  Severance Hospital
  Seoul, Seoul-t'ukpyolsi, Republic of Korea

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.
• HH

  Hyuk Hur, n/a

  Professor
  Severance Hospital
  s, Seoul-t'ukpyolsi, Republic of Korea

  Disclosure information not submitted.

Senior Author(s)

• BM

  Byung Soh Min, n/a

  Professor
  Severance Hospital
  Seodaemun gu, Seoul-t'ukpyolsi, Republic of Korea

  All of the relevant financial relationships listed below have been mitigated.
  This individual has no financial relationships with ineligible companies.

Purpose/Background: Perioperative hyperglycemia has been consistently associated with adverse outcomes. Recently, multiple studies have revealed that high glycemic variability, rather than just hyperglycemia, has a more detrimental impact on postoperative outcomes. However, its impact on postoperative complications following colorectal cancer surgery remains unclear. This study investigates the relationship between serum glucose variability and the incidence of postoperative complications in patients undergoing elective colorectal cancer surgery. This study aimed to determine whether serum glycemic variability increases the risk of postoperative complications in patients undergoing elective colorectal cancer surgery.

Methods/Interventions: This retrospective cohort study included 2077 patients who underwent elective colorectal cancer surgery at a single tertiary center from March 2018 to December 2019. The primary objective was to assess the association between serum glucose variability, measured as the coefficient of variation (CV) of glucose levels at predefined time points pre- and post-surgery, and the occurrence of postoperative complications within 30 days. Complications were categorized and graded according to the Clavien-Dindo classification.

Results/Outcomes: Patients were divided into three tertiles based on their CV of glucose levels: Tertile 1 ( < 20%), Tertile 2 (20%-36%), and Tertile 3 (≥36%). The non-diabetic patients in the highest tertile (≥36% CV) had a significantly longer postoperative hospital stay (12.6 ± 12.6 days) and longer operation duration (331.2 ± 189.6 minutes) compared to those in the lowest tertile. Diabetic patients in the highest tertile also showed longer postoperative hospital stays (13.9 ± 14.4 days) and operation durations (319.6 ± 162.4 minutes). Higher glycemic variability was significantly associated with an increased risk of postoperative complications. Univariate and multivariate analyses revealed that glycemic variability (CV) was an independent risk factor for complications of grade III or higher (Odds Ratio: 1.0374, 95% CI: 1.0203 to 1.0548, p < 0.0001). Other significant factors included male sex and type of surgery (open laparotomy vs. laparoscopic/robotic).

Conclusion/Discussion: Higher serum glycemic variability is associated with an increased risk of postoperative complications in patients undergoing colorectal cancer surgery. Therefore, close monitoring and management of glucose levels in the perioperative period are recommended.

Demographic Characteristics, perioperative outcomes, complications
BMI: body mass index, SD: standard deviation, ASA: American Society of Anesthesiologists, * P value indicated with an asterisk (*) mark means statistically significant differences among groups † Complications were graded by Clavien-Dindo classification

Univariate and Multivariate analysis of factors associated with postoperative complications (≥ CD grade III)
ASA: American Society of Anesthesiologists, CD grade: Clavien-dindo classification, DM: Diabetes mellitus * P value indicated with an asterisk (*) mark means statistically significant differences among groups