Impact of preoperative haemoglobin A1c levels on postoperative outcomes in adults undergoing major noncardiac surgery: A systematic review
Authors' conclusion
Current evidence suggested that higher preoperative HbA1c levels were associated with increased odds of postoperative complications and extended length of stay in adults undergoing major noncardiac surgery. Further high-quality studies would be needed to quantify the risks posed and determine whether early intervention improves outcomes.
Study context
- Population
- Adults undergoing major noncardiac surgery with haemoglobin A1c (HbA1c) measured within 6 months before surgery; studies published January 2012–July 202320 observational studies
- Comparison
- Incremental preoperative HbA1c levels
- Outcome
- Postoperative outcomes
Pooled result
As reported in the abstract
Postoperative outcomes by preoperative HbA1c
- Higher preoperative HbA1c associated with increased odds of overall postoperative complications, postoperative acute kidney injury, anastomotic leak, surgical site infections and increased LOS
- Each 1% increase in preoperative HbA1c associated with increased odds of these complications
- No association with reoperations and 30-day mortality
- Literature highly variable for composite major complications, perioperative cardiovascular events, readmissions, postoperative pneumonia and systemic thromboembolism
Original publication
Impact of preoperative haemoglobin A1c levels on postoperative outcomes in adults undergoing major noncardiac surgery: A systematic review. Diabet Med. Published 10 June 2024. doi:10.
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