چکیده (انگلیسی):

Background: A chronic state of impaired glucose metabolism affects multiple components of the immune
system, possibly leading to an increased incidence of post-operative infections. Such infections increase
morbidity, length of stay, and overall cost. This study evaluates the correlation between elevated preoperative
glycosylated hemoglobin (HbA1c) and post-operative infections.
Study design: Adult patients undergoing non-emergent procedures across all surgical subspecialties from
January 2010 to July 2014 had a preoperative HbA1c measured as part of their routine pre-surgical
assessment. 2200 patient charts (1100 < 6.5% HbA1c and1100 6.5% HbA1c) were reviewed for evidence
of post-operative infection (superficial surgical site infection, deep wound/surgical space abscess,
pneumonia, and/or urinary tract infection as defined by Centers for Disease Control criteria) within 30
days of surgery.
Results: Patients with HbA1c < 6.5% and those with HbA1c 6.5% showed no statistically significant
difference in overall infection rate (3.8% in the HbA1c < 6.5% group vs. 4.5% in the HbA1c 6.5% group,
p ¼ 0.39). Both linear regression and multivariate analysis did not identify HbA1c as an individual
predictor of infection. Elevated HbA1c was, however, predictive of significantly increased risk of postoperative
infection when associated with increased age (81 years of age) or dirty wounds.
Conclusions: The risk factors of post-operative infection are multiple and likely synergistic. While preoperative
HbA1c level is not independently associated with risk of post-operative infection, there are
scenarios and patient subgroups where pre-operative HbA1c is useful in predicting an increased risk of
infectious complications in the post-operative period.