Elevated Postoperative Blood Glucose and Preoperative Hemoglobin A1C Are Associated with Increased Wound Complications Following Total Joint Arthroplasty

Abstract

Patients with a mean postoperative blood glucose of >200 mg/dL or a preoperative hemoglobin A1C level of >6.7% are at increased risk for wound complications following elective primary total joint arthroplasty. These results show that poor preoperative and postoperative glucose control is independently associated with wound complications.

Diabetes Confers Little to No Increased Risk of Postoperative Complications After Hip Fracture Surgery in Geriatric Patients

“…This designation will not capture as much heterogeneity in the population with diabetes as would a hemoglobin A1c value. Although the value of hemoglobin A1c in predicting risk of postoperative events has yet to be determined, recent data indicate a correlation between elevated hemoglobin A1c and increased risk of infection and wound complications after joint arthroplasty [25]. This level of granularity is unavailable in our analysis owing to the data source and is a limitation of the study.…”

Prevention of periprosthetic joint infection

“…Between 8% and 22% of patients who undergo TJA have diabetes, 25 and about one third have undiagnosed hyperglycemia. 26 Diabetes, especially when uncontrolled, is a significant risk factor for SSI.…”

Postoperative hyperglycemia and adverse outcomes in patients undergoing colorectal surgery: results from the Michigan surgical quality collaborative database

“…This metabolic abnormality has been linked with several postoperative adverse outcomes such as surgical site infection (SSI), myocardial infarction, sepsis, and death across several surgical specialties including cardiac, orthopedic, vascular, and general surgery [1][2][3][4][5]. While insulin administration may mitigate some of these postoperative risks, the target perioperative blood glucose concentration for each patient population is yet to be determined.…”