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Haemoglobin A1c as a predictor of postoperative hyperglycaemia and complications after major colorectal surgery
Örebro University, School of Health and Medical Sciences.ORCID iD: 0000-0003-2636-4745
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2009 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 96, no 11, p. 1358-1364Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Hyperglycaemia following major surgery increases morbidity, but may be improved by use of enhanced-recovery protocols. It is not known whether preoperative haemoglobin (Hb) A1c could predict hyperglycaemia and/or adverse outcome after colorectal surgery. METHODS: Some 120 patients without known diabetes underwent major colorectal surgery within an enhanced-recovery protocol. HbA1c was measured at admission and 4 weeks after surgery. All patients received an oral diet beginning 4 h after operation. Plasma glucose was monitored five times daily. Patients were stratified according to preoperative levels of HbA1c (within normal range of 4.5-6.0 per cent, or higher). RESULTS: Thirty-one patients (25.8 per cent) had a preoperative HbA1c level over 6.0 per cent. These had higher mean(s.d.) postoperative glucose (9.3(1.5) versus 8.0(1.5) mmol/l; P < 0.001) and C-reactive protein (137(65) versus 101(52) mg/l; P = 0.008) levels than patients with a normal HbA1c level. Postoperative complications were more common in patients with a high HbA1c level (odds ratio 2.9 (95 per cent confidence interval 1.1 to 7.9)). CONCLUSION: Postoperative hyperglycaemia is common among patients with no history of diabetes, even within an enhanced-recovery protocol. Preoperative measurement of HbA1c may identify patients at higher risk of poor glycaemic control and postoperative complications.

Place, publisher, year, edition, pages
Oxford: Blackwell , 2009. Vol. 96, no 11, p. 1358-1364
National Category
Medical and Health Sciences Surgery Gastroenterology and Hepatology
Research subject
Medicine
Identifiers
URN: urn:nbn:se:oru:diva-11778DOI: 10.1002/bjs.6724PubMedID: 19847870OAI: oai:DiVA.org:oru-11778DiVA, id: diva2:349789
Available from: 2010-09-08 Created: 2010-09-08 Last updated: 2017-12-12Bibliographically approved

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Ljungqvist, Olle

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