Haemoglobin A1c (HbA1C) in Non-diabetic and Diabetic Vascular Patients. Is HbA1C an Independent Risk Factor and Predictor of Adverse Outcome?

Abstract

Suboptimal HbA1c levels may hold prognostic significance in patients without diabetes undergoing vascular surgery.

Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 1: pathophysiological considerations

“…Such patients received more blood products, and spent more time in the ICU ( P  = 0.030) and the hospital ( P  < 0.001) than metabolically normal patients 21. These findings are in agreement with the results of other observational studies indicating worse outcomes after cardiac, abdominal and vascular procedures in the presence of increased HbA1c concentrations 32, 33, 34…”

Preoperative glucose as a screening tool in patients without diabetes

“…In comparison, reports utilizing pre-operative HbA1c found increased risk of deep sternal wound infection after CABG when controlling for diabetes diagnosis, 29 higher post-operative complications after colorectal surgery in patients without known diabetes, 30 increased 30-day morbidity in patients without diabetes undergoing vascular surgery, 31 but no association with post-operative infection risk in non-diabetic cardiac surgery patients, 32 with increased HbA1c levels. The patients included in our study had no known diabetes, and HbA1c measurements were not available.…”

Physiologic considerations of Enhanced Recovery After Surgery (ERAS) programs: implications of the stress response

“…Patients undergoing colorectal surgery with elevated HbA1c (glycosylated hemoglobin) and no history of diabetes had a higher rate of postoperative infections. [43][44][45] Also, elevated glucose levels on both the day of surgery and the first postoperative day were associated with a higher incidence of complications and increased levels of CRP, indicating an association with the inflammatory response. 46 Postoperative complications following cardiac surgery, particularly serious infections, have been shown to be directly proportional to the degree of insulin resistance, as assessed using the HNC at the end of cardiac surgery.…”