Phyo Kyaw Myint1, Stephanie Owen2, Lyndsay Pearce3, Matthew F Greig4, Hui Sian Tay4, Caroline McCormack4, Kathryn McCarthy5, Susan J Moug6, Michael J Stechman7, Jonathan Hewitt2. 1. AGEING; Epidemiology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK Department of Medicine for the Elderly, Aberdeen Royal Infirmary, Aberdeen, UK. 2. University Hospital Llandough, Cardiff, UK. 3. Department of General Surgery, Manchester Royal Infirmary, Manchester, UK. 4. Department of Medicine for the Elderly, Aberdeen Royal Infirmary, Aberdeen, UK. 5. Department of General Surgery, North Bristol NHS Trust, Bristol, UK. 6. Department of General Surgery, Royal Alexandra Hospital, Paisley, Greater Glasgow, UK. 7. Department of General Surgery, University Hospital of Wales, Cardiff, UK.
Abstract
BACKGROUND: The purpose of the study is to examine the prevalence of hyperglycaemia in an older acute surgical population and its effect on clinically relevant outcomes in this setting. METHODS: Using Older Persons Surgical Outcomes Collaboration (OPSOC) multicentre audit data 2014, we examined the prevalence of admission hyperglycaemia, and its effect on 30-day and 90-day mortality, readmission within 30 days and length of acute hospital stay using logistic regression models in consecutive patients, ≥65 years, admitted to five acute surgical units in the UK hospitals in England, Scotland and Wales. Patients were categorised in three groups based on their admission random blood glucose: <7.1, between 7.1 and 11.1 and ≥11.1 mmol/L. RESULTS: A total of 411 patients (77.25±8.14 years) admitted during May and June 2014 were studied. Only 293 patients (71.3%) had glucose levels recorded on admission. The number (%) of patients with a blood glucose <7.1, 7.1-11.1 and ≥11.1 mmol/L were 171 (58.4), 99 (33.8) and 23 (7.8), respectively. On univariate analysis, admission hyperglycaemia was not predictive of any of the outcomes investigated. Although the characteristics of those with no glucose level were not different from the included sample, 30-day mortality was significantly higher in those who had not had their admission glucose level checked (10.2% vs 2.7%), suggesting a potential type II error. CONCLUSION: Despite current guidelines, nearly a third of older people with surgical diagnoses did not have their glucose checked on admission highlighting the challenges in prognostication and evaluation research to improve care of older frail surgical patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
BACKGROUND: The purpose of the study is to examine the prevalence of hyperglycaemia in an older acute surgical population and its effect on clinically relevant outcomes in this setting. METHODS: Using Older Persons Surgical Outcomes Collaboration (OPSOC) multicentre audit data 2014, we examined the prevalence of admission hyperglycaemia, and its effect on 30-day and 90-day mortality, readmission within 30 days and length of acute hospital stay using logistic regression models in consecutive patients, ≥65 years, admitted to five acute surgical units in the UK hospitals in England, Scotland and Wales. Patients were categorised in three groups based on their admission random blood glucose: <7.1, between 7.1 and 11.1 and ≥11.1 mmol/L. RESULTS: A total of 411 patients (77.25±8.14 years) admitted during May and June 2014 were studied. Only 293 patients (71.3%) had glucose levels recorded on admission. The number (%) of patients with a blood glucose <7.1, 7.1-11.1 and ≥11.1 mmol/L were 171 (58.4), 99 (33.8) and 23 (7.8), respectively. On univariate analysis, admission hyperglycaemia was not predictive of any of the outcomes investigated. Although the characteristics of those with no glucose level were not different from the included sample, 30-day mortality was significantly higher in those who had not had their admission glucose level checked (10.2% vs 2.7%), suggesting a potential type II error. CONCLUSION: Despite current guidelines, nearly a third of older people with surgical diagnoses did not have their glucose checked on admission highlighting the challenges in prognostication and evaluation research to improve care of older frail surgical patients. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Authors: Phyo Kyaw Myint; Stephanie Owen; Kathryn McCarthy; Lyndsay Pearce; Susan J Moug; Michael J Stechman; Jonathan Hewitt; Ben Carter Journal: Geriatr Gerontol Int Date: 2018-03-01 Impact factor: 2.730
Authors: Hui Sian Tay; Adrian D Wood; Ben Carter; Lyndsay Pearce; Kathryn McCarthy; Michael J Stechman; Phyo K Myint; Jonathan Hewitt Journal: Front Surg Date: 2020-11-16
Authors: Jonathan Hewitt; Stephanie Owen; Ben R Carter; Michael J Stechman; Hui Sian Tay; Matthew Greig; Caroline McCormack; Lyndsay Pearce; Kathryn McCarthy; Phyo K Myint; Susan J Moug Journal: Geriatrics (Basel) Date: 2019-10-16