An interesting study out of Brigham and Women’s hospital in Boston ties poor glycemic control–defined as an A1c of 8% or more–to longer hospital stays for non-cardiac surgery.
There’s no surprise there, since previous studies have confirmed that people with poorly controlled blood sugars take longer to recover from surgery and are prone to more complications.
But the study also shows that patients with diabetes who had A1c’s of less than 6.5% also were more likely to experience longer hospital stays than patients whose A1c’s ranged from 6.5% to 8%.
The study, “Preoperative A1C and Clinical Outcomes in Patients With Diabetes Undergoing Major Noncardiac Surgical Procedures,” appeared recently in the ADA publication Diabetes Care (http://care.diabetesjournals.org/content/37/3/611.abstract).
While it concluded that statistics show a higher probability of longer hospital stays for patients with 8%-plus A1c’s, it did not address why A1c’s below 6.5% also increased the probability of longer stays.
It may be that persons with lower A1c’s arrive at the hospital considerably closer to the threshold for hypoglycemia than patients in the 6.5% to 8% range. The stresses of surgery and post-op routines could lead to slower recovery times for such individuals.
For the study, which drew data from the National Surgical Quality Improvement Program database and Brigham and Women’s Hospital’s own patient database, identified patients from 2005 to 2010 who had been admitted to the hospital for at least one day after undergoing non-cardiac surgery.
Diabetic patients with identified A1c’s were divided into four groups:
1. Patients with A1c’s of less than 6.5% (109 patients)
2. Patients with A1c’s ranging from 6.5% to 8% (209 patients)
3. Patients with A1c’s ranging from above 8% to 10% (91 patients)
4. Patients with A1c’s of 10% and above (47 patients)