Association of preoperative blood glucose level with delirium after non-cardiac surgery in diabetic patients
Background Hyperglycemia has shown a negative association with cognitive dysfunction. We analyzed patients with high preoperative blood glucose level and hemoglobin A1c (HbA1c) level to determine the prevalence of postoperative delirium. Methods We reviewed a database of 23,532 patients with diabete...
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| Format: | Article |
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Korean Society of Anesthesiologists
2024-04-01
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| Series: | Korean Journal of Anesthesiology |
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| Online Access: | http://ekja.org/upload/pdf/kja-23301.pdf |
| _version_ | 1797235319848828928 |
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| author | Soo Jung Park Ah Ran Oh Jong-Hwan Lee Kwangmo Yang Jungchan Park |
| author_facet | Soo Jung Park Ah Ran Oh Jong-Hwan Lee Kwangmo Yang Jungchan Park |
| author_sort | Soo Jung Park |
| collection | DOAJ |
| description | Background Hyperglycemia has shown a negative association with cognitive dysfunction. We analyzed patients with high preoperative blood glucose level and hemoglobin A1c (HbA1c) level to determine the prevalence of postoperative delirium. Methods We reviewed a database of 23,532 patients with diabetes who underwent non-cardiac surgery. Acute hyperglycemia was defined as fasting blood glucose > 140 mg/dl or random glucose > 180 mg/dl within 24 h before surgery. Chronic hyperglycemia was defined as HbA1c level above 6.5% within three months before surgery. The incidence of delirium was compared according to the presence of acute and chronic hyperglycemia. Results Of the 23,532 diabetic patients, 21,585 had available preoperative blood glucose level within 24 h before surgery, and 18,452 patients reported levels indicating acute hyperglycemia. Of the 8,927 patients with available HbA1c level within three months before surgery, 5,522 had levels indicating chronic hyperglycemia. After adjustment with inverse probability weighting, acute hyperglycemia was related to higher incidence of delirium (hazard ratio: 1.33, 95% CI [1.10,1.62], P = 0.004 for delirium) compared with controls without acute hyperglycemia. On the other hand, chronic hyperglycemia did not correlate with postoperative delirium. Conclusions Preoperative acute hyperglycemia was associated with postoperative delirium, whereas chronic hyperglycemia was not significantly associated with postoperative delirium. Irrespective of chronic hyperglycemia, acute glycemic control in surgical patients could be crucial for preventing postoperative delirium. |
| first_indexed | 2024-04-24T16:46:05Z |
| format | Article |
| id | doaj.art-40b74b07911449909e78de98d5953ba9 |
| institution | Directory Open Access Journal |
| issn | 2005-6419 2005-7563 |
| language | English |
| last_indexed | 2024-04-24T16:46:05Z |
| publishDate | 2024-04-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Korean Journal of Anesthesiology |
| spelling | doaj.art-40b74b07911449909e78de98d5953ba92024-03-29T07:56:40ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632024-04-0177222623510.4097/kja.233018949Association of preoperative blood glucose level with delirium after non-cardiac surgery in diabetic patientsSoo Jung Park0Ah Ran Oh1Jong-Hwan Lee2Kwangmo Yang3Jungchan Park4 Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Center for Health Promotion, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaBackground Hyperglycemia has shown a negative association with cognitive dysfunction. We analyzed patients with high preoperative blood glucose level and hemoglobin A1c (HbA1c) level to determine the prevalence of postoperative delirium. Methods We reviewed a database of 23,532 patients with diabetes who underwent non-cardiac surgery. Acute hyperglycemia was defined as fasting blood glucose > 140 mg/dl or random glucose > 180 mg/dl within 24 h before surgery. Chronic hyperglycemia was defined as HbA1c level above 6.5% within three months before surgery. The incidence of delirium was compared according to the presence of acute and chronic hyperglycemia. Results Of the 23,532 diabetic patients, 21,585 had available preoperative blood glucose level within 24 h before surgery, and 18,452 patients reported levels indicating acute hyperglycemia. Of the 8,927 patients with available HbA1c level within three months before surgery, 5,522 had levels indicating chronic hyperglycemia. After adjustment with inverse probability weighting, acute hyperglycemia was related to higher incidence of delirium (hazard ratio: 1.33, 95% CI [1.10,1.62], P = 0.004 for delirium) compared with controls without acute hyperglycemia. On the other hand, chronic hyperglycemia did not correlate with postoperative delirium. Conclusions Preoperative acute hyperglycemia was associated with postoperative delirium, whereas chronic hyperglycemia was not significantly associated with postoperative delirium. Irrespective of chronic hyperglycemia, acute glycemic control in surgical patients could be crucial for preventing postoperative delirium.http://ekja.org/upload/pdf/kja-23301.pdfblood glucosecognitive dysfunctionemergence deliriumglycated hemoglobinhyperglycemiamortalitypostoperative delirium |
| spellingShingle | Soo Jung Park Ah Ran Oh Jong-Hwan Lee Kwangmo Yang Jungchan Park Association of preoperative blood glucose level with delirium after non-cardiac surgery in diabetic patients Korean Journal of Anesthesiology blood glucose cognitive dysfunction emergence delirium glycated hemoglobin hyperglycemia mortality postoperative delirium |
| title | Association of preoperative blood glucose level with delirium after non-cardiac surgery in diabetic patients |
| title_full | Association of preoperative blood glucose level with delirium after non-cardiac surgery in diabetic patients |
| title_fullStr | Association of preoperative blood glucose level with delirium after non-cardiac surgery in diabetic patients |
| title_full_unstemmed | Association of preoperative blood glucose level with delirium after non-cardiac surgery in diabetic patients |
| title_short | Association of preoperative blood glucose level with delirium after non-cardiac surgery in diabetic patients |
| title_sort | association of preoperative blood glucose level with delirium after non cardiac surgery in diabetic patients |
| topic | blood glucose cognitive dysfunction emergence delirium glycated hemoglobin hyperglycemia mortality postoperative delirium |
| url | http://ekja.org/upload/pdf/kja-23301.pdf |
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