The aim of this study was to identify emergency general surgery patients at risk for post-operative hyperglycemia and worse outcomes and to evaluate the correlation of HbA1c levels and postoperative glucose levels with outcomes. We hypothesized that emergency general surgery patients with an elevated preoperative HbA1c are at risk of developing post-operative hyperglycemia and poor outcomes.
Diabetes mellitus (DM) has become a worldwide epidemic and its incidence continues to increase dramatically. The Centers for Disease Control (CDC) has estimated that there are approximately 29.1 million people with diabetes in the United States (U.S.), about 9.3% of the total population. Patients with diabetes are more likely to require surgery than the general population. It is estimated that every 1 in 4 diabetic patients will undergo surgery at some stage in their life. Perioperative hyperglycemia in patients requiring emergency general surgery increases the risk of postoperative infections and other complications. Measurement of preoperative HbA1c helps to get an overall picture of the average blood sugar levels over a period of months. It is well established that diabetic patients undergoing emergency general surgery are at increased risk of mortality and morbidity. Furthermore, the relationship between inadequate preoperative glucose controls as demonstrated by preoperative HbA1c and the postoperative random blood sugar with adverse in hospital and 30-day outcomes has not been explored.
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