Association Between Preoperative Blood Glucose Level and Hospital Length of Stay for Patients Undergoing Appendectomy or Laparoscopic Cholecystectomy

To evaluate the effect of preoperative blood glucose (POBG) level on hospital length of stay (LOS) in patients undergoing appendectomy or laparoscopic cholecystectomy.

RESEARCH DESIGN AND METHODS

We conducted a retrospective cohort study of patients aged ≥18 years who had undergone either appendectomy or laparoscopic cholecystectomy procedures between 2005 and 2016 at a tertiary medical center in Taiwan. The association between POBG level and LOS was evaluated using a multivariable quasi-Poisson regression with robust variance. Multiple imputations were performed to replace missing values.

RESULTS

We included a total of 8,291 patients; 4,025 patients underwent appendectomy (appendectomy group) and 4,266 underwent laparoscopic cholecystectomy (laparoscopic cholecystectomy group). In the appendectomy group, patients with POBG levels of ≥123 mg/dL (adjusted relative risk [aRR], 1.19; 95% CI, 1.06–1.33) had a 19% higher risk of having a LOS of >3 days than did those with POBG levels of <106 mg/dL. In the laparoscopic cholecystectomy group, patients with POBG levels of ≥128 mg/dL also had a significantly higher risk of having a LOS of >3 days (aRR, 1.17; 95% CI, 1.07–1.29) than did those with POBG levels of <102 mg/dL. A positive dose–response curve between POBG and an adjusted risk of a LOS of >3 days was observed, despite the curve starts to flatten at a POBG level of approximately 130 mg/dL.

CONCLUSIONS

We demonstrated that a higher POBG level was significantly associated with a prolonged LOS for patients undergoing appendectomy and laparoscopic cholecystectomy. The optimal POBG level may be lower than that commonly perceived.