Takeaway
- Presence of diabetes and higher HbA1c are independently associated with a higher risk of adverse outcomes after surgery.
- Diabetes was found to be prevalent in 30% of inpatients undergoing surgery.
Why this matters
- Surgical procedures generally increase the stress on the patients, leading to increased risk for morbidity and mortality.
- Previous studies have reported conflicting results regarding the association between HbA1c level and surgical outcomes.
Study design
- Prospective, observational study of 7565 surgical inpatients (normoglycemia, n=2457; pre-diabetes, n=2825; diabetes, n=2283; age, ≥54 years) between May 2013 and January 2016.
- Patients were followed for 6 months.
- Funding: None disclosed.
Key results
- After adjustments, diabetes was found to be associated with increased 6-month mortality (aOR, 1.29; P=.014) after surgery.
- Diabetes also showed increased risk for major complications (aOR, 1.32; P<.001), ICU admission (aOR, 1.50; P<.001), mechanical ventilation (aOR, 1.67; P<.001) and hospital LOS (adjusted incidence rate ratio [aIRR], 1.08; P<.001).
- Each 1% increase in HbA1c was associated with increase in major complications (aOR, 1.07; P=.030), ICU admission (aOR, 1.14; P<.001) and hospital LOS (aIRR, 1.05; P<.001).
Limitations
- Risk for residual confounding.
References
References