Clinical Significance of Post-Operative Hyperglycemia in Nondiabetic Patients Undergoing Definitive Surgery for Gastrointestinal Fistula

BACKGROUND: To evaluate the association between peri-operative hyperglycemia and adverse events in patients with gastrointestinal (GI) fistulas without a pre-operative diagnosis of diabetes mellitus who were undergoing definitive surgery. METHODS: Pre-operative and all post-operative blood glucose concentrations (BG) were retrieved for 363 consecutive patients undergoing GI reconstruction from September 2012 to December 2015. Normoglycemic (BG <125 mL/dL), mild hyperglycemia (125-199 mL/dL), and severe hyperglycemia (≥200 mL/dL) were defined using the highest BG found within the first 48 h post-operatively. Outcomes of interest included 30-d mortality rate and re-operation, time of enteral nutrition resumption, and infectious and non-infectious complications. RESULTS: More than half of the nondiabetic patients (61.4%) experienced hyperglycemia post-operatively. The degree of hyperglycemia correlated with patient age, American Society…