Preoperative HbA1c and Postoperative Outcomes in Spine Surgery: A Systematic Review and Meta-Analysis
Abstract
Study design Systematic review and meta-analysis. Objective To perform a systematic review and meta-analysis of previous studies on HbA1c in preoperative risk stratification in patients undergoing spinal procedures and provide an overview of the consensus recommendations. Summary of background data Diabetes mellitus (DM) and hyperglycemia have been shown to be independent risk factors for increased surgical complications. Glycated Hemoglobin A1C (HbA1c), a surrogate for long term glycemic control, is an important preoperative parameter that may be optimized to reduce surgical complications and improve patient-reported outcomes. However, comprehensive systematic reviews on preoperative HbA1c and postoperative outcomes in spine surgery have been limited. Methods We systematically searched PubMed, EMBASE, Scopus, and Web-of-Science for English-language studies from inception through April 5 th , 2022, including references of eligible articles. The search was conducted according to PRISMA guidelines. Only studies in patients undergoing spine surgery with preoperative HbA1c values and postoperative outcomes available were included. Results A total of 22 articles (18 retrospective cohort studies, 4 prospective observational studies) were identified with level of evidence III or greater. The majority of studies (n=17) found that elevated preoperative HbA1c was associated with inferior outcomes or increased risk of complications. Random-effect meta-analysis demonstrated that patients…
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Current data suggest an optimal A1C goal between 7% and 8% preoperatively, as it is associated with better glycemic management in the perioperative period and decreased length of hospital stay.
“Current data also suggest an optimal A1C goal between 7% and 8% preoperatively, as it is associated with better glycemic management in the perioperative period and decreased length of hospital stay (139,141-144).”
From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [144]
Cites
The PRISMA 2020 statement: An updated guideline for reporting systematic reviews
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., et al. (2021) · BMJ · doi:10.1136/bmj.n71 · Cited by 108,283 · see citing works
Expenditures and health status among adults with back and neck problems
Martin, B. I. (2008) · JAMA · doi:10.1001/jama.299.6.656 · Cited by 1,531 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026
American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., et al. (2026) · Diabetes Care · doi:10.2337/dc26-s016 · Cited by 80 · see citing works
- Authors
- Tao, X., Matur, A. V., Palmisciano, P., Conteh, F. S., Onyewadume, L., Duah, H. O., Shukla, G., Vorster, P., Gupta, S., Chilakapati, S. S., & Adogwa, O.
- Affiliations
- University of Cincinnati (US)
- University of Kentucky (US)
- Medical College of Wisconsin (US)
- Department of Neurosurgery, Ruby Memorial Hospital, Morgantown, WV
- The University of Texas Southwestern Medical Center (US)
- Corresponding author
- Adogwa, Owoicho
- ORCID
- Venue
- Spine
- Published
- 2023-05-05
- Volume
- 48
- Issue
- 16
- Pages
- 1155-1165
- ISSN
- 0362-2436 (ISSN-L)
- OpenAlex
- W4372259385
- Cited by
- 49
- References
- 2
- Citations by year
- 2026: 19 · 2025: 17 · 2024: 9 · 2023: 4
- FWCI
- 1.80
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Spine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
- Keywords
- HbA1c, spinal surgery, preoperative risk stratification, postoperative complications, surgical site infection, diabetes mellitus, hyperglycemia, glycemic control, patient-reported outcomes
- MeSH terms
- Diabetes Mellitus, Glycated Hemoglobin, Humans, Retrospective Studies, Risk Factors, Surgical Wound Infection, Observational Studies as Topic
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
