Publication:

Post-operative hyperglycaemia in non-diabetic patients following elective gynaecological surgeries: incidence and risk factors

Background There is a dearth of information on the incidence, risk factors, and impact of postoperative hyperglycemia following Gynaecological surgeries. This study explores the incidence and predictors of postoperative hyperglycemia following elective Gynaecological surgeries and its association with postoperative outcomes.

Methods The non-diabetic patients admitted for elective gynaecological surgeries who met inclusion criteria and were willing to participate were enrolled. Blood glucose was checked in the post-operative period at 2,6,12,24, and 48 hours, respectively. Hyperglycemia was defined as any blood glucose value of >126 mg/dl and clinically significant hyperglycemia as >180 mg/dl. All patients were followed up for 30 days. Outcome measures were the incidence of post-operative hyperglycemia and the relation of hyperglycemia with peri-operative parameters and infections.

Results Out of the 200 patients, post-operative hyperglycaemia was observed in 61.5% of patients and 12.5% had severe hyperglycaemia. The mean BMI of patients with hyperglycaemia (25.8±3.8kg/m2) was significantly more than euglycemic ones (24.4±4.0kg/m2 (p=0.019)). Procedures lasting >2 hours were significantly associated with hyperglycemia (p=0.002) and its severity (p=0.006). Post-operative infectious complications and the need for therapeutic antibiotics were higher among hyperglycaemic patients (p=0.053).

Conclusions Postoperative hyperglycemia in non-diabetic patients following elective gynaecologic surgeries is associated with an increased risk of infections. Postoperative monitoring of blood glucose should be done for all patients. If universal monitoring is not feasible, then patients with high BMI undergoing open abdominal surgeries lasting more than 2 hours should undergo vigilant post-operative monitoring for hyperglycemia.