Preoperative hemoglobin A1C level and preoperative capillary blood glucose level as predictors of clinical outcomes of patients who underwent low to intermediate risk, non- cardiovascular surgical procedures.
- Author:
Mary Grace Marquez
- Publication Type:Journal Article
- From:
Journal of the Philippine Medical Association
2018;97(1):24-32
- CountryPhilippines
- Language:English
-
Abstract:
BACKGROUND:Hyperglycemia has been associated with poor clinical outcomes in both diabetic and
non-diabetic patients. The aim of this study is to determine if preoperative hemoglobin A1C level and capillary
blood glucose level can be used as predictors of clinical outcomes of patients who underwent low to
intermediate risk, non-cardiovascular surgical procedures.
METHODOLOGY:A Single Center Cohort Retrospective Study was conducted and data were obtained from lists of
patients who underwent low to intermediate risk, non-cardiovascular surgical procedures admitted for more
than one day from January 2016 to December 2016. Chart review was done and provided information on
demographics, presence and status of co-morbidities, availability of hemoglobin A1C ninety days prior to
surgery or pre-operative capillary blood sugar, and surgical outcomes (length of hospital stay, surgical site
infection, postoperative sepsis, acute renal failure or mortality). Comparison of outcomes among different levels
of A1C was analyzed using Analysis of Variance and Fisher’s exact test. Comparison of outcomes between
normal and elevated CBG was analyzed using independent t-test and Fisher’s exact test. The level of significance
was set at 5%.
RESULTS:A total of one hundred forty five patients were included in the final analysis. Of which, 69 patients had an
HbA1C available within 90 days prior to surgery with the mean A1C at 8.04% ± 2.48%, and 93 patients had
pre-operative capillary blood glucose with a mean value of 125.16 ± 55.94. Longer hospital stay was shown in
patients with A1C level of 8-10% (4.7 ± 5.16 days). However, the association is insignificant with a P value of
0.1412. There were no significant difference in the length of hospital stay in patients with CBG level of <140mg/dL
and ≥140mg/dL, with a mean value of 2.9014 ± 1.7167 days and 2.8636 ± 1.2834 days, respectively.
(P = 0.9244) .There were too few events to meaningfully evaluate for secondary outcomes.
CONCLUSION: Our study suggests that neither preoperative capillary blood glucose level nor hemoglobin A1C is
significantly associated with longer hospital stay. But the findings on patients with hemoglobin A1C values of
8.0% - 10% warrants further investigation. Providing a preoperative intervention to improve glycemic control in
individuals with hemoglobin A1C values of 8.0% - 10% may improve surgical outcomes, but prospective studies
are needed.
- Full text:Preoperative hemoglobin A1C level.pdf
