Cambridge risk score, new hyperglycemia, and complications in surgical patients without diabetes

Abstract

Aims: Our study examined the association between the Cambridge Risk Score (CRS), new hyperglycemia (NH), and complications in patients undergoing elective surgery.

Methods: In this retrospective cross-sectional study, adult surgical patients, without diabetes, with NH (blood glucose ≥140 mg/dL) were identified, and the CRS was calculated. We used univariate regression models to evaluate the relationship between CRS and NH with 30-day readmission, length of stay (LOS), and complications. Models were stratified by surgical specialty (cardiac/vascular, general, orthopedic, neurologic).

Results: Of 10,531 patients in the study, 24 % had NH. After adjusting for covariates, the CRS was associated with increased odds of complications [OR 2.09; 95%CI:1.69, 2.59] and NH [OR 1.95; 95%CI:1.66, 2.29]. NH was associated with increased odds of 30-day readmission [β 1.60; 95%CI:1.31, 1.96], and increased LOS [β 0.64; 95%CI:0.59, 0.68]. When stratified by surgery type, the CRS was associated with increased LOS in neurosurgery, decreased LOS in orthopedics, and increased odds of complications and NH in neurosurgery and orthopedics.

Conclusion: The CRS is associated with NH, complications, and LOS in patients undergoing elective neurosurgery, orthopedic surgery, and general surgery. This suggests that CRS may have potential to help identify surgical patients at high risk for NH and complications.

Keywords: Cambridge Risk Score; New hyperglycemia; Perioperative hyperglycemia; Surgical complications.