The surgical literature has demonstrated an association between high perioperative HgbA1c and increased surgical morbidity in cardiac surgical procedures. However, there is a lack of information for abdominopelvic surgical procedures. The objective of this study was to determine if there is an association between HgbA1c levels and postoperative complications in diabetic gynecologic oncology patients undergoing laparotomy, and to determine if there is a HgbA1c cut-off at which the postoperative complications increases.METHODS:
A retrospective cohort study was performed. Preoperative HgbA1c level within 3 months of surgery, as well as other key preoperative, intraoperative and postoperative variables were abstracted. Descriptive statistics were performed on demographic and baseline data. A Student’s t-test was used to determine if there was a difference in HgbA1c between patients who did and did not experience a postoperative complication. Regression analysis was performed to determine if there was a HgbA1c cut-off at which the rate of complications significantly increased.RESULTS:
113 diabetic gynecologic oncology patients with HgbA1c levels available were identified between 1/1/2009 to 12/30/2013. There was no statistically significant difference in HgbA1c between those who experienced any complication (6.99 vs 6.95; p=0.86), any serious complication (6.90 vs. 7.14; p=0.44) or wound complication (7.0 vs 6.96; p=0.05). A HgbA1c cut-off where the risk of complications increased could not be determined (AUC 0.51, 0.53, 0.49 for any complication, serious complication, wound complication, respectively).CONCLUSION:
A mildly elevated HgbA1c is not associated with increased postoperative or wound complications, and surgery should not be delayed for patients with a suspected or confirmed malignancy.