دورية أكاديمية
أعرض في EDS

Detection and Management of Perioperative Hyperglycemia at a Tertiary Cancer Center.

التفاصيل البيبلوغرافية
العنوان: Detection and Management of Perioperative Hyperglycemia at a Tertiary Cancer Center.
المؤلفون: Taylor JS; Department of Gynecologic Oncology and Reproductive Medicine, M. D. Anderson Cancer Center, Houston, USA. Jstaylor1@mdanderson.org., Fellman BM; Department of Biostatistics, M. D. Anderson Cancer Center, Houston, USA., Raty S; Department of Anesthesiology, M. D. Anderson Cancer Center, Houston, USA., Lasala J; Department of Anesthesiology, M. D. Anderson Cancer Center, Houston, USA., Iniesta MD; Department of Gynecologic Oncology and Reproductive Medicine, M. D. Anderson Cancer Center, Houston, USA., Cain KE; Department of Pharmacy Clinical Programs, M. D. Anderson Cancer Center, Houston, USA., Horner AA; Department of Breast Surgical Oncology, M. D. Anderson Cancer Center, Houston, USA., Bruno M; Department of Surgical Oncology, M. D. Anderson Cancer Center, Houston, USA., Folloder JP; Department of Surgical Oncology, M. D. Anderson Cancer Center, Houston, USA., Knippel SL; Department of Thoracic and Cardiovascular Surgery, M. D. Anderson Cancer Center, Houston, USA., Khanh V; Department of Internal Medicine, M. D. Anderson Cancer Center, Houston, USA., Popovich S; Department of Perioperative Medicine, M. D. Anderson Cancer Center, Houston, USA., Katz MHG; Department of Surgical Oncology, M. D. Anderson Cancer Center, Houston, USA., Best C; Department of Endocrinology, M. D. Anderson Cancer Center, Houston, USA., Thosani S; Department of Endocrinology, M. D. Anderson Cancer Center, Houston, USA.
المصدر: Annals of surgical oncology [Ann Surg Oncol] 2024 May; Vol. 31 (5), pp. 3017-3023. Date of Electronic Publication: 2024 Feb 12.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Springer Country of Publication: United States NLM ID: 9420840 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1534-4681 (Electronic) Linking ISSN: 10689265 NLM ISO Abbreviation: Ann Surg Oncol Subsets: MEDLINE
أسماء مطبوعة: Publication: 2005- : New York, NY : Springer
Original Publication: New York, NY : Raven Press, c1994-
مواضيع طبية MeSH: Hyperglycemia*/diagnosis , Hyperglycemia*/etiology , Diabetes Mellitus*/diagnosis , Neoplasms*, Humans ; Blood Glucose ; Glycated Hemoglobin ; Perioperative Care ; Retrospective Studies
مستخلص: Introduction: To improve the detection and management of perioperative hyperglycemia at our tertiary cancer center, we implemented a glycemic control quality improvement initiative. The primary goal was to decrease the percentage of diabetic patients with median postoperative glucose levels > 180 mg/dL during hospitalization by 15% within 2 years.
Methods: A multidisciplinary team standardized preoperative screening, preoperative, intraoperative, and postoperative hyperglycemia management. We included all patients undergoing nonemergent inpatient and outpatient operations. We used a t test, rank sum, chi-square, or Fisher's exact test to assess differences in outcomes between patients at baseline (BL) (10/2018-4/2019), during the first phase (P1) (10/2019-4/2020), second phase (P2) (5/2020-12/2020), and maintenance phase (M) (1/2021-10/2022).
Results: The analysis included 9891 BL surgical patients (1470 with diabetes), 8815 P1 patients (1233 with diabetes), 10,401 P2 patients (1531 with diabetes) and 30,410 M patients (4265 with diabetes). The percentage of diabetic patients with median glucose levels >180 mg/dL during hospitalization decreased 32% during the initiative (BL, 20.1%; P1, 16.9%; P2, 12.1%; M, 13.7% [P < .001]). We also saw reductions in the percentages of diabetic patients with median glucose levels >180 mg/dL intraoperatively (BL, 34.0%; P1, 26.6%; P2, 23.9%; M, 20.3% [P < .001]) and in the postanesthesia care unit (BL, 36.0%; P1, 30.4%; P2, 28.5%; M, 25.8% [P < .001]). The percentage of patients screened for diabetes by hemoglobin A1C increased during the initiative (BL, 17.5%; P1, 52.5%; P2, 66.8%; M 74.5% [P < .001]).
Conclusions: Our successful initiative can be replicated in other hospitals to standardize and improve glycemic control among diabetic surgical patients.
(© 2024. Society of Surgical Oncology.)
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معلومات مُعتمدة: National Institutes of Health through M.D. Anderso NIH Clinical Center
المشرفين على المادة: 0 (Blood Glucose)
0 (Glycated Hemoglobin)
تواريخ الأحداث: Date Created: 20240212 Date Completed: 20240410 Latest Revision: 20240410
رمز التحديث: 20240410
DOI: 10.1245/s10434-024-14986-7
PMID: 38347330
قاعدة البيانات: MEDLINE
الوصف
تدمد:1534-4681
DOI:10.1245/s10434-024-14986-7