Evidence map›Paper›PMID 34711544›Full record

ArticleBMJ open diabetes research & care2021

Quality gaps in screening and monitoring for postoperative hyperglycemia in a Canadian hospital: a retrospective cohort study.

Shannon M Ruzycki, Tyrone G Harrison, Edwin Enns, Julie McKeen, Karmon Helmle, Anna Cameron

Abstract read
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Article in BMJ open diabetes research & care, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Shannon M RuzyckiDepartment of Medicine, University of Calgary, Calgary, Alberta, Canada shannon.ruzycki@ucalgary.ca.ORCID 0000-0002-8122-2910
Tyrone G HarrisonDepartment of Medicine, University of Calgary, Calgary, Alberta, Canada.
Edwin EnnsDepartment of Medicine, University of Calgary, Calgary, Alberta, Canada.
Julie McKeenDepartment of Medicine, University of Calgary, Calgary, Alberta, Canada.
Karmon HelmleDepartment of Medicine, University of Calgary, Calgary, Alberta, Canada.ORCID 0000-0001-5620-3104
Anna CameronDepartment of Obstetrics and Gynecology, Cumming School of Medicine, Calgary, Alberta, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEvidence-based preoperative, intraoperative and postoperative glycemic management may reduce poor surgical outcomes. Previous studies suggest that quality gaps in perioperative glycemic management may be common. RESEARCH DESIGN AND

methodsThis retrospective cohort study used administrative health and laboratory data from a single center to estimate quality gaps in perioperative glycemic management in patients with and without diabetes between April 2019 and March 2020. We examined the proportion of patients with preoperative hemoglobin A1c (HbA1c) measurement, postoperative point-of-care testing (POCT) for glucose, hyperglycemia, and basal bolus insulin regimens. We compared the median length of stay (LOS) in patients with and without postoperative hyperglycemia, adjusted for age and sex.

resultsThere were 6576 patients in our cohort; 1165 (17.8%) had diabetes. Most patients with diabetes had an HbA1c measured prior to surgery (n=697, 59.8%). Postoperatively, 16.9% of patients with diabetes had no POCT monitoring (n=197) and 65.7% had hyperglycemia (n=636). Only 35.9% of patients who received insulin had a basal bolus insulin regimen (n=229). Patients with diabetes who had postoperative hyperglycemia had a longer median LOS compared with those who did not have postoperative hyperglycemia (8.4 days (95% CI 7.5 to 9.4) and 6.7 days (95% CI 6.3 to 7.1), respectively). In patients without diabetes, median LOS was 7.4 days (95% CI 4.4 to 10.4) for those with hyperglycemia and 5.2 days (95% CI 5.1 to 5.4) for those with in-target glucose.

conclusionsQuality gaps in perioperative glycemic management include measurement of blood glucose after surgery and treatment of postoperative hyperglycemia. These gaps may contribute to longer LOS.

Indexed as

HyperglycemiaCanadaCohort StudiesHospitalsHumansRetrospective Studiesgeneral surgeryhospitalizationquality improvement

Identifiers

PMID34711544
PMCPMC8557293

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