ASSOCIATION OF GLYCATED HEMOGLOBIN LEVEL AND POSTOPERATIVE COMPLICATIONS IN GENERAL SURGICAL PROCEDURES
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Keywords
HbA1c, postoperative complications, general surgical procedures
Abstract
Objectives: To assess the association between HbA1c levels and the incidence of postoperative complications in patients undergoing general surgical procedures.
Materials and Methods: This cross sectional study was conducted at General Surgery Department, Khyber Teaching Hospital Peshawar, Pakistan from November, 2023 to April, 2024. It included 150 patients who met the selection criteria. Data were collected from medical records and patient interviews, covering preoperative details such as age, gender, BMI, diabetes status, comorbidities, and HbA1c levels within one month before surgery. Intraoperative data included the type and duration of surgery and anesthesia used, while postoperative data documented complications, hospital stay length, readmission rates, and mortality rates.
Results: The mean age of all enrolled patients (n=250) was 47.14±8.71 years. The gender distribution was 60% male and 40% female. Age groups were as follows: 4.7% were 18-30 years, 14.7% were 31-40 years, 40% were 41-50 years, and 40.7% were 50-60 years. HbA1c levels showed 36% below 6.4% and 64% above 6.5%. Surgery types included 36.7% emergency and 63.3% elective. Hospital stays were less than 5 days for 49.3%, 6-10 days for 33.3%, and more than 10 days for 17.3%. Emergency surgery had 35.2% no complications vs. 64.8% for elective; renal complications were evenly split, while respiratory, cardiac, and multi organ failure were more common in elective surgeries. Deaths were higher in elective surgeries (66.7%). Hospital stay length was significantly shorter for emergency surgery (p = 0.03), and HbA1c levels significantly impacted complication rates, with fewer complications in those with HbA1c <6.5% (42.9%) and more in those >8.5% (31.7%), showing a significant trend (p = 0.03).
Conclusion: It was concluded that elevated preoperative HbA1c levels significantly increase the risk of postoperative complications. To improve patient safety and recovery, it is crucial to manage high HbA1c levels proactively before elective surgery. Effective glycemic control can significantly reduce complications and enhance surgical outcomes.
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Dr Jahanzeb Akhtar
House Officer, General Surgery Department, Bolan Medical Complex Hospital Quetta, Pakistan
Dr Aiman Liaqat
Post Graduate Resident Trainee, General Surgery Department, Khyber Teaching Hospital Peshawar, Pakistan
Dr Saad Inayat Ullah
Post Graduate Resident Trainee, General Surgery Department, Hayatabad Medical Complex Peshawar, Pakistan
Dr Shakeeb Ahmad Khan
Post Graduate Resident, Emergency Medicine, Lady Ready Hospital Peshawar, Pakistan
Dr Mian Hussnain Ali
Medical Officer, Department of Emergency, Akbar Medical Complex, Pakistan
Muhammad Khurram Zia
Associate Professor of Surgery, Liaquat College of Medicine and Dentistry and Darul Sehat Hospital Karachi, Pakistan