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

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.