• Perioperative Glycemic Control and Postoperative Complications in Patients Undergoing Emergency General Surgery: What is the Role of HbA1c? (January 2018)

    Faisal Jehan, MD, Muhammad Khan, MD, Joseph V. Sakran, MD, Mohammad Khreiss, MD, Terence O’Keeffe, MD, Albert Chi, MD, Narong Kulvatunyou, MD, Arpana Jain, MD, El Rasheid Zakaria, MD, PhD, and Bellal Joseph, MD
    CME 1 CME Credit(s)

    Learning Objectives:

    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.

    Impact Statement:

    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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    This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint providership of the American College of Surgeons and the American Association for the Surgery of Trauma. The American College of Surgeons is accredited by the ACCME to provide continuing medical education (CME) for physicians.

    AMA PRA Category 1 Credits™

    The American College of Surgeons designates this journal-based activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    Of the AMA PRA Category 1 Credits™ listed above, a maximum of 1 credit meets the requirements for Self-Assessment.

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