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- Title
Hyperglycemia Occuring During Non-Cardiac Surgery Is Predictive of Post-Op Infections in Non-Diabetics.
- Authors
Balkin, Michael S.; Smith, Virginia; Brown, Lawrence
- Abstract
The effect of operative stress on blood glucose and its relationship to postoperative infection was studied in our community hospital over a six and half month period of time from 10/17/05 to 5/31/06. We prospectively obtained glucose values immediately pre-operatively and post-operatively via glucose meter on all patients undergoing the four non-cardiac surgical procedures which have been targeted by the Institute for Hospital for reduction of post-operative infection. We also included patients undergoing laminectomies. Records of all these patients were assessed for post-operative infections. There were 313 out of a total of 362 patients who had no previous history of diabetes and these are the subject of this report. Surgical procedures fell into the following categories: 5% colon surgery, 15% hysterectomies, 49% joint surgery, 26% laminectomies and 5% vascular surgery. During surgery blood glucose levels rose from a mean 105±18mg/dl to 132±36mg/dL, but a substantial minority experienced a greater rise. 29.8% of patients with a pre-operative glucose of <140mg/dL, and 10.8% with a pre-operutive glucose of < 100mg/dL, finished their surgery with a glucose of > 140mg/dL. An average of 2.2 ±1.1 liters of fluid, in most cases Ringer's lactate, was administered. No patient received IV dextrose. Six patients experienced post-operative infections, most of which were superficial wound infections. Five of these six patients were in the group with a pre-operative glucose of < 140 and a post-operative glucose of > 140. In these five patients, glucose rose from 110±10 mg/dL to 169.5±23mg/dL. All of these patients had received prophylactic antibiotic therapy immediately preoperatively. 3 out of these 5 patients were considered to have developed new infections and the remaining two to have suffered recurrent infections. We conclude that a substantial minority of our patients not known to be diabetic experienced a significant rise in glucose during surgery. Most post-operative infections occurred in this group and therefore monitoring the effects of surgical stress on blood glucose may be predictive of post-operative infections.
- Subjects
HYPERGLYCEMIA; BLOOD sugar; INFECTION; POSTOPERATIVE care; DIABETES; LAMINECTOMY; HYSTERECTOMY; ANTIBIOTICS
- Publication
Diabetes, 2007, Vol 56, pA111
- ISSN
0012-1797
- Publication type
Article