Relationship of perioperative hyperglycemia and postoperative infection in elective abdominal surgery in non diabetic patient

Nabal Kumar Mishra; Mansoor Banday; Atul Jain; Malwinder Singh; Tanweer Karim; Subhajeet Dey

Volume : VII, Issue : VII, July - 2018

Relationship of perioperative hyperglycemia and postoperative infection in elective abdominal surgery in non diabetic patient

Nabal Kumar Mishra, Mansoor Banday, Atul Jain, Malwinder Singh, Tanweer Karim, Subhajeet Dey

Abstract :

BACKGROUND:Postoperative infections are common in surgical patients leading to increased morbidity and mortality. Patients are susceptible to stress–induced hyperglycemia following operation, independent of the diabetic status. Perioperative hyperglycemia in critically ill surgical patients increases the risk of postoperative infections and its consequences. Despite 30 million operations performed in United States and much more in India each year, the clear association between perioperative blood glucose (BG) level and postoperative infection (POI) remain ill–defined for the majority of surgery patients.

AIM:To identify the relationship of perioperative hyperglycemia and post–operative infection in elective abdominal surgery in non diabetic patients.

MATERIAL AND METHODS:This is a prospective, observational study of 150 patients who were non diabetic and underwent an elective abdominal surgery. The primary outcome of interest was POI, defined as the occurrence of 1 or more reports of pneumonia, wound infections, urinary tract infections, and sepsis in the first 30 days after surgery and one year after surgery in case of use of prosthesis. The primary predictor of interest was peri–operative hyperglycemia, defined as the RBS of >150mg/dl in the perioperative period (just prior to surgery and within 12 hr and within 24 hr after the skin closure). In the study 500 patient were screened for perioperative hyperglycemia out of which only 150(30%) patient had RBS>150mg/dl in perioperative period.

RESULTS AND CONCLUSIONS:There was significant change in RBS in the perioperative period. The overall incidence of POI in 150 cases of Elective Abdominal Surgeries was 7.33%. Wound infection was observed in 7 cases (4.66%) and 4 cases (2.66%) had respiratory complication.

Risk factors like old age, contaminated wound, higher ASA grade and increased duration of surgery are associated with increased POI.The most common complication was wound infection