Glycemic Control and Postoperative Mortality

Preoperative glycosylated hemoglobin didn't predict 30-day mortality, and the relation between immediate postoperative glycemic control and mortality was not straightforward.

In observational studies, associations between glycemic control and operative outcomes have varied. Nevertheless, some surgeons insist on tight glycemic control before diabetic patients undergo nonemergency surgery (NEJM JW Gen Med May 1 2014 and J Bone Joint Surg Am 2014; 96:50). For example, an orthopedic surgeon recently canceled a total knee replacement for one of my diabetic outpatients because his preoperative glycosylated hemoglobin (HbA_1c) was 7.7%; this orthopedist doesn't operate if HbA_1c is >7.5%. And, for one of my diabetic inpatients, a surgeon recently delayed nonemergent noncardiac surgery “until all glucoses are under 200 mg/dL for 48 hours.”

In this latest study, Duke University researchers retrospectively examined the assoc…

Reviewing Author

Allan S. Brett, MD

Disclosures

Nothing to disclose

Allan S. Brett, MD

Disclosures

Nothing to disclose

Glycemic Control and Postoperative Mortality

Topics

Reviewing Author