Title: Role of Glycosylated Haemoglobin (HbA1c) as Predictor of Post-Operative Hyperglycemia and Complication after Major Gastro-Intestinal Surgery
Authors: Dr Narendranath Swain, Dr Y. Tejkumar, Dr Jyoti Mohan Tosh, Dr Manindra Nayak
DOI: https://dx.doi.org/10.18535/jmscr/v6i4.92
Abstract
Aim: Prediction of post operative complications from pre operative HbA1c levels & its relation on post op. morbidity & overall recovery of patient after major gastro-intestinal surgery.
Materials and Methods: A total no. of 60 patients who were planned for major GI surgery were taken into study and were divided into two groups as per pre- op HbA1c level (<6% or >6%).The clinical data & final results were analysed in relation to pre op. and post op. hyperglycemia.
Observation: It is observed that post-op. day1 FBS is raised in all patients, however post-op day 1 hyperglycemia is present in 60% of patients in HbA1c> 6% and 22.5% in patients in HbA1c < 6%. The post-op. complications occur more i.e. 65% in HbA1c >6% and 20% in HbA1c <6%. The infectious complication is more i.e. 50% in HbA1c >6% and 5% in HbA1c <6%. The post-op. recovery i.e. early bowel movement, early oral feeding are also delayed in HbA1c >6% group. The post-op. hospital staying is also more in this group. The post-op. CPR response is also significantly raised in HbA1c > 6% group.
Conclusion: That pre operative HbA1c may be used to identify patients at higher risk of poor post-op. glycemic control and prediction of post- op. complications, recovery & morbidity after major gastro-intestinal surgery.
Keywords: Hyperglycemia, HbA1c, Gastro intestinal surgery.
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