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Glycemic instability of non-diabetic patients after spine surgery: a prospective cohort study

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Abstract

Purpose

Blood glucose (BG) dysregulation is a well-known condition for patients sustaining medical adverse events, such as sepsis or myocardial infarction. However, it has never been described following spine surgery. Our purpose was to assess postoperative glycemic dysregulation of non-diabetic patients undergoing spine surgery and determine if this is related to any complications within a 3-month postoperative period.

Methods

All the non-diabetic patients undergoing spine surgery in our center were prospectively included over a 6-month period. BG capillary measures were collected from the preoperative fasting period to the end of postoperative Day 3, six times a day. Patients were followed for 3 months after surgery.

Results

Data collected from 75 patients were eventually analyzed. A significant increase of BG level was observed from the preoperative to the second postoperative hour (P < 0.0001), remaining significantly elevated until Day 3 (P < 0.0001). Significant correlations were found between perioperative factors (age, smoking, revision status, instrumentation, operation time, blood loss and transfusion) and glycemic parameters. Day 2 mean BG level was found significantly higher for patients surgically revised than those not revised (P = 0.04).

Conclusions

Non-diabetic patients experience a statistically significant increase in BG levels in the first 3 days following a spine surgery. This increase in BG might be correlated with postsurgical complications.

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Abbreviations

BG:

Blood glucose

D0:

Day of surgery

D1/2/3:

First/second/third day following surgery

BF−0.5/BF+2/L−0.5/L+2/D−0.5/D+2:

30 min before and 2 h after breakfast, lunch and dinner

HGI:

Hyperglycemic index

SD:

Standard deviation

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Acknowledgments

Dr. David Bichara for improving the overall quality of the manuscript. Financial support for this study was entirely provided by our department.

Conflict of interest

The authors have no conflict of interests related to this study.

Author information

Authors and Affiliations

  1. Service de chirurgie orthopédique et traumatologique, Hôpital Beaujon, 100 boulevard Général Leclerc, 92100, Clichy, France

    Jean Langlois, Benjamin Bouyer, Cyril Dauzac & Pierre Guigui

  2. Unité d’Epidémiologie et de Recherche Clinique, Hôpital Beaujon, 100 boulevard Général Leclerc, 92100, Clichy, France

    Béatrice Larroque

Authors
  1. Jean Langlois
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  2. Benjamin Bouyer
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  3. Béatrice Larroque
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  4. Cyril Dauzac
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  5. Pierre Guigui
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Corresponding author

Correspondence to Jean Langlois.

Additional information

Béatrice Larroque deceased before manuscript acceptance.

Clinical trial registration number: NCT01975883.

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Langlois, J., Bouyer, B., Larroque, B. et al. Glycemic instability of non-diabetic patients after spine surgery: a prospective cohort study. Eur Spine J 23, 2455–2461 (2014). https://doi.org/10.1007/s00586-014-3489-2

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  • DOI: https://doi.org/10.1007/s00586-014-3489-2

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