Perioperative medicine & outcomes
Association Between Glycemic Variability and Persistent Acute Kidney Injury After Noncardiac Major Surgery: A Multicenter Retrospective Cohort Study
Authors' conclusion
GV measured within 48 hours postoperative period is an independent risk factor for persistent AKI in patients undergoing noncardiac surgery.
Study context
- Population
- Patients undergoing major noncardiac surgery at 3 medical centers in eastern China, January 2015–September 20237,714 external validation cases
- Participants
- 10,937 patients
- Exposure
- Higher vs lower glycemic variability within 48 hours postoperative
- Outcome
- Persistent AKI
- Follow-up
- 7-day postoperative window
Methodological detailsmulticentre, external validation cohort
- Multicentre
- External validation cohort
Main finding
As reported in the abstract
Odds ratio (95% CI)
CV (higher GV)
1.26(1.08–1.46)
MAGE (higher GV)
1.31(1.15–1.49)
BGRI (higher GV)
1.18(1.08–1.29)
- Persistent acute kidney injury (AKI) incidence
- 274 (2.5%)
Observational data: associations, not effects.
Further findings
Risk identification of persistent AKI vs models without glycemic factors
- Mean amplitude of glycemic excursions (MAGE) AUC
- 0.768, P = .011
- Blood glucose risk index (BGRI) AUC
- 0.764, P = .014
- MAGE cutoff
- 3.78
- BGRI cutoff
- 3.02
Classification performance using cutoffs (internal and external validation)
- MAGE AUC, internal cohort
- 0.768
- MAGE AUC, external cohort
- 0.777
Original publication
Association Between Glycemic Variability and Persistent Acute Kidney Injury After Noncardiac Major Surgery: A Multicenter Retrospective Cohort Study. Anesth Analg. Published 14 February 2025. doi:10.
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