High blood glucose levels after surgery may be an important risk factor for infection at the surgical site in patients having general surgery, according to a report in the September issue of Archives of Surgery, one of the JAMA/Archives journals.
Surgical site infection accounts for 14 percent to 17 percent of hospital-acquired infections, making it the third most common type of infection acquired at health-care facilities and the most common among patients having surgery, according to background information in the article. "Studies have shown that these infections prolong the hospital length of stay after surgery, increase rehospitalization rates and dramatically increase the use of emergency services and health care costs," the authors write.
Ashar Ata, M.B.B.S., M.P.H., and colleagues at Albany Medical College, Albany, N.Y., reviewed the medical records of patients who had general or vascular surgery between Nov. 1, 2006, and April 30, 2009. A total of 2,090 patients were randomly selected from a quality improvement database and then matched with medical records to obtain information about postoperative glucose values. These values were available for 1,561 patients, including 559 who had vascular surgery, 226 who had colorectal surgery and 776 who had a type of general surgery other than colorectal.
Overall, 7.42 percent of the patients developed surgical site infections, including 14.11 percent of those who had colorectal surgery, 10.32 percent who had vascular surgery and 4.36 percent of those who had other general surgery.
Among general surgery patients, factors associated with surgical site infection included age, emergency status, physical status as classified by the American Society of Anesthesiologists, time in surgery, diabetes and high postoperative blood glucose (hyperglycemia). However, after adjusting for postoperative blood glucose level, all other factors were not significant predictors of infection. A subanalysis of colorectal surgery patients found that a postoperative serum glucose level higher than 140 milligrams per deciliter was the only significant predictor of surgical site infection.
Among vascular surgery patients, operative time and diabetes were the only significant predictors of surgical site infection, which was not associated with postoperative hyperglycemia.
Hyperglycemia may impair the immune system, and insulin may have anti-inflammatory and other anti-infective activities. However, it is possible that the accumulation of other risk factors for surgical site infection cause hyperglycemia rather than vice versa; hence, further study is needed, the authors note.
"In conclusion, we found postoperative hyperglycemia to be the most important risk factor for surgical site infection in general and colorectal cancer surgery patients, and serum glucose levels higher than 110 milligrams per deciliter were associated with increasingly higher rates of post-surgical infection," they continue. "If hyperglycemia is confirmed in future prospective studies with better postoperative glucose data to be an independent risk factor for postsurgical infection in general surgery patients, this would give surgeons a modifiable variable to reduce the incidence of postoperative infection."
Infections at point of surgery account for 14-17% of all hospital infections in patients and ranks third in causes for all post surgical infection. According to a report in the September issue of Archives of Surgery, a JAMA journal, increased blood sugar levels after surgery are linked to procedures in the operating room.
Ashar Ata, M.B.B.S., M.P.H., and colleagues at Albany Medical College, Albany state:
Studies have shown that these infections prolong the hospital length of stay after surgery, increase rehospitalization rates and dramatically increase the use of emergency services and health care costs.
Post surgery glucose levels were reviewed in 1,561 patients. Of these, vascular surgery took place in 559 (36%) persons, 226 (14%) had colon related surgery and 776 (50%) were a part of general surgery procedure. Almost seven and a half percent of the patients developed surgical site infections. Vascular patients at 10%, colorectal at 14% and 4% of the total having general surgeries.
Making adjustments for age, emergency status, physical status as classified by the American Society of Anesthesiologists, time in surgery, diabetes, it was concluded that almost all of these factors were not significant predictors of infections. A further analysis of colorectal surgery patients found that a postoperative serum glucose level higher than 140 milligrams per deciliter was a sign of surgical site infection, and in vascular patients, time of operation and existing diabetic conditions influenced signs of surgical site infection, although not associated with hyperglycemia.
Why are these infections dangerous? Hyperglycemia may impair the immune system, and insulin may have anti-inflammatory and other anti-infective activities. Much further investigation is necessary, as is the case in most scientific endeavors.
The authors conclude:
We found postoperative hyperglycemia to be the most important risk factor for surgical site infection in general and colorectal cancer surgery patients, and serum glucose levels higher than 110 milligrams per deciliter were associated with increasingly higher rates of post-surgical infection. If hyperglycemia is confirmed in future prospective studies with better postoperative glucose data to be an independent risk factor for postsurgical infection in general surgery patients, this would give surgeons a modifiable variable to reduce the incidence of postoperative infection.
How can I lower my blood sugar after surgery?
Post-Surgery Management Tips.Eating appropriate foods after surgery (whole grains, fruits, vegetables, and lean protein).Frequently checking your glucose levels..Taking your insulin or other diabetes medications as prescribed..How long does it take for high blood sugar to go away?
Without a diagnosis of prediabetes or diabetes, it should take one to two hours for a blood sugar spike to come down. You can opt for a walk or a workout to accelerate the process.