Impact of HbA1c level on perioperative hemodynamics, recovery room stay and postoperative discharge time in diabetic patients undergoing total hip arthroplasty

Prem Raj Singh , Shailendra Singh , Anamika Gupta , Mohd Parvez Khan , Vinita Singh , Gyan Prakash Singh
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引用次数: 2

Abstract

Background & aim

Diabetic patients are susceptible for surgical site infections, periprosthetic infections, and increased hospital stay. Present study was aimed to determine the influence of HBA1c level on perioperative hemodynamic, recovery room stay and postoperative discharge times in patient undergoing total hip arthroplasty.

Methods

After institutional ethical clearance, this prospective, observational, study was conducted on 70 diabetic patients aged 18–65 years of either sex. Patients under study were enrolled into either group A (<7.5 HbA1c) or group B (≥7.5 HbA1c). On the morning of surgery fasting blood sugar and serum potassium levels were checked. Random blood sugar (RBS) at time of incision, at the time of closure, and postoperatively at 6, 12, 18, and 24 h were measured. Intraoperative hemodynamic variables, recovery room stay and hospital stay times were noted.

Results

Association of hypertension (p value 0.001), gm intake (p value 0.003), post-operative blood glucose levels (p value < 0.001), duration of recovery room stay and total duration of hospital stay were found significantly higher in group B (p value < 0.001). Surgical site infection (SSI), duration of illness, ECG changes, and postoperative complications were not significant. Although incidence of SSI was more in group B (p value 0.303).

Conclusion

Diabetic patients, not on insulin therapy, with no renal impairment, with ASA grading II-III, and with no other contraindication for spinal anaesthesia; 7.5% can be used as a new cut-off for level of HbA1c for total hip arthroplasty.

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糖化血红蛋白水平对糖尿病全髋关节置换术患者围手术期血流动力学、康复室时间及术后出院时间的影响
背景,目的糖尿病患者易发生手术部位感染、假体周围感染和住院时间增加。本研究旨在探讨HBA1c水平对全髋关节置换术患者围术期血流动力学、康复室时间及术后出院次数的影响。方法经过机构伦理审查,本前瞻性观察性研究对70例年龄在18-65岁的糖尿病患者进行了研究。研究中的患者被分为A组(HbA1c≥7.5)或B组(HbA1c≥7.5)。手术当日上午检查空腹血糖和血清钾水平。测定切开时、缝合时及术后6、12、18、24 h随机血糖(RBS)。记录术中血流动力学变量、康复室住院时间和住院时间。结果高血压(p值0.001)、gm摄入量(p值0.003)、术后血糖水平(p值<0.001), B组康复室住院时间和总住院时间显著高于B组(p值<0.001)。手术部位感染(SSI)、病程、心电图变化和术后并发症无显著性差异。B组SSI发生率较高(p值0.303)。结论:未接受胰岛素治疗的糖尿病患者,无肾脏损害,ASA分级为II-III级,无其他脊髓麻醉禁忌症;7.5%可作为全髋关节置换术中HbA1c水平的新临界值。
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来源期刊
Journal of Arthroscopy and Joint Surgery
Journal of Arthroscopy and Joint Surgery Medicine-Orthopedics and Sports Medicine
CiteScore
0.60
自引率
0.00%
发文量
1
期刊介绍: Journal of Arthroscopy and Joint Surgery (JAJS) is committed to bring forth scientific manuscripts in the form of original research articles, current concept reviews, meta-analyses, case reports and letters to the editor. The focus of the Journal is to present wide-ranging, multi-disciplinary perspectives on the problems of the joints that are amenable with Arthroscopy and Arthroplasty. Though Arthroscopy and Arthroplasty entail surgical procedures, the Journal shall not restrict itself to these purely surgical procedures and will also encompass pharmacological, rehabilitative and physical measures that can prevent or postpone the execution of a surgical procedure. The Journal will also publish scientific research related to tissues other than joints that would ultimately have an effect on the joint function.
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