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Cited by 24Hyperglycemia and glycemic control in critically ill and hospitalized patientsCardiac, Anesthesia and Surgical OutcomesDiabetes Management and Research

The effect of elevated A1C on immediate postoperative complications: a prospective observational study

Open access
Chen, Pinxia, Hallock, Katherine K., Mulvey, Christie L., Berg, Arthur S., Cherian, Verghese T.·2018·Clinical Diabetes
DOI 10.2337/cd17-0081PMC PMC5898174
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Abstract

IN BRIEF This study examined whether elevated A1C in patients with diabetes is associated with a higher incidence of postoperative infections and other complications. Researchers followed 50 noncardiac surgical patients for 7 postoperative days. Half of the patients had an A1C <7% and the other half had an A1C ≥7%. The two groups were otherwise comparable except that the higher-A1C group had significantly higher pre-induction and postoperative blood glucose levels, with wider variability in the first 24 hours after surgery. During the first postoperative week, 11 patients developed complications, of whom 10 were in the higher-A1C group. Elevated A1C, unlike a single preoperative blood glucose value, may predict difficult postoperative glucose control and postsurgical complications.

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  • 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 [142]

    The Results and Discussion report that patients with A1C ≥7% had higher postoperative glucose levels and wider variability than those with A1C <7%, supporting an association with perioperative glycemic management. The study does not identify 7–8% as an optimal preoperative goal or show that this range decreases total hospital stay; its Results report intensive care unit stay, which is a different measure. (LLM, conf=0.88)

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Research works printed but not linked: 20

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Authors
Chen, P., Hallock, K. K., Mulvey, C. L., Berg, A. S., & Cherian, V. T.
Affiliations
  • Department of Anesthesiology and Perioperative Medicine and
  • Pennsylvania State University (US)
Corresponding author
Cherian, Verghese T.
ORCID
Venue
Clinical Diabetes
Publisher
American Diabetes Association
Published
2018-04-01
Volume
36
Issue
2
Pages
128-132
ISSN
  • 0891-8929 (ISSN-L)
  • 1945-4953
DOI
10.2337/cd17-0081
PMC
PMC5898174
OpenAlex
W2777613228
Cited by
24
References
0
Citations by year
2026: 2 · 2025: 3 · 2024: 5 · 2023: 4 · 2022: 5 · 2021: 2 · 2020: 2 · 2019: 1
FWCI
0.65
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Diabetes (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • 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 › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
HbA1c, diabetes mellitus, postoperative complications, postoperative infection, non-cardiac surgery, glycemic control, glycemic variability, preoperative blood glucose

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