Abstract
Diabetes mellitus (DM) is known as an important risk factor for surgical site infection(SSI) in spine surgery. A chronic state of impaired glucose metabolism affects multiple components of the immune system, possibly leading to an increased incidence of post-operative infection. Such infection increases morbidity, length of stay, and overall cost. The present study was designed to assess the correlation between pre-operative hemoglobin A1c (HbA1c) and the incidence of post-operative infection in surgical patients undergoing decomperssive spine operations. Forty diabetic patients who underwent decompressive spine surgery at different levels of spine were included in this retrospective study. These include 23 females and 17 males with mean age of 57.5 years. The patients data were collected from hospitals and private clinics archives including value of preoperative hemoglobin A1c, random blood sugar, postoperative C-reactive protein (CRP) and white blood cells count (WBC) as a diagnostic laboratory tests for identification of postoperative infection in follow-up periods. The overall rate of infection in our study was 12.5%, which was categorized into 2 groups (Uncontrolled diabetes hemoglobin A1c >7 and controlled hemoglobin A1C ≤7), so the rate of infection was 19.2% among patients with uncontrolled diabetes compared with 0% among patients with controlled diabetes (p=0.143). The mean hemoglobin A1c among patients with uncontrolled diabetes who developed infection was 9.72% compared with 7.34% among those with no infection (p <0.001) In conclusion, diabetic patients whose blood glucose levels were poorly controlled before surgery as indicated by high hemoglobin A1c were at high risk for postoperative wound infection. Preoperative hemoglobin A1c above 7.34% could serve as a threshold value for significant increased risk of postoperative surgical site infection. Key words: Diabetes Mellitus, HbA1C, decompressive spine surgery, infection, complications.
Highlights
Diabetes mellitus (DM) is known as an important risk factor for surgical site infection (SSI) in spine surgery
The mean hemoglobin A1c among patients with uncontrolled diabetes who developed infection was 9.72% compared with 7.34% among those with no infection (p
Many studies reported that diabetes is a risk factor for development of wound infection after spinal surgery, there are only few articles showed correlation between hemoglobin A1c and rate of infection in diabetic patients following spinal procedures
Summary
Diabetes mellitus (DM) is known as an important risk factor for surgical site infection (SSI) in spine surgery. A chronic state of impaired glucose metabolism affects multiple components of the immune system, possibly leading to an increased incidence of post-operative infection Such infection increases morbidity, length of stay, and overall cost. Factors known to affect the risk of surgical site infection includes: age, ASA score, obesity, diabetes mellitus, smoking, previous surgeries, previous infections, previous radiation therapy, chronic skin conditions, and how closely the patient adheres to postoperative wound care instructions[4,5,6,7,8,9]. The present study was designed to assess the correlation between pre-operative hemoglobin A1c and the incidence of post-operative infection in surgical patients undergoing decomperssive spine surgery. A1c above which the risk of postoperative infection after decompressive spine surgery that increases significantly in patients with diabetes
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
