Quality Gaps in Screening and Monitoring for Postoperative Hyperglycemia in a Canadian Hospital

University of Calgary

Status: Completed

Conditions: Hyperglycemia; Surgery; Diabetes Mellitus

Treatments: Other: Exposure - postoperative hyperglycemia

Study type: Observational

Funder types: Other

Identifiers

NCT04679025

HREBA.CC-19-0157

Details and patient eligibility

About

Patients with and without diabetes who have postoperative hyperglycemia have worse outcomes than patients with in-target blood sugars. Previous quality improvement work suggests numerous barriers and clinical inertia may contribute to quality gaps in glycemic management for surgical patients. Using a framework for perioperative glycemic management, we sought to measure quality gaps in perioperative glycemic care.

This cross-sectional study used administrative data to measure the proportion of surgical patients with and without known diabetes who underwent preoperative hemoglobin A1c measurement, postoperative point-of-care testing for glucose (POCT), had hyperglycemia, and received basal bolus insulin regimens for treatment. We performed an exploratory analysis comparing length of stay (LOS) in patients with and without diabetes who had and did not have postoperative hyperglycemia.

Enrollment: 7,633 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Underwent inpatient surgical procedure at the Foothills Medical Centre between Apr 1 2019 and March 31 2020
• Stayed in hospital for more than 24-hours after surgery

Exclusion criteria

• Younger than 18 years of age

Trial design

7,633 participants in 4 patient groups

Diabetes with postoperative hyperglycemia

Description:

Patients with known diabetes (Discharge Abstract Database or hemoglobin A1c \> 6.5%) who had postoperative hyperglycemia (point of care test \> 10.0 mmol/L).

Treatment:

Other: Exposure - postoperative hyperglycemia

Diabetes without postoperative hyperglycemia

Description:

Patients with known diabetes (Discharge Abstract Database or hemoglobin A1c \> 6.5%) who did not have postoperative hyperglycemia (point of care test \> 10.0 mmol/L).

No diabetes with postoperative hyperglycemia

Description:

Patients without known diabetes (Discharge Abstract Database or hemoglobin A1c \> 6.5%) who had postoperative hyperglycemia (point of care test \> 10.0 mmol/L).

Treatment:

Other: Exposure - postoperative hyperglycemia

No diabetes and no postoperative hyperglycemia

Description:

Patients without known diabetes (Discharge Abstract Database or hemoglobin A1c \> 6.5%) who did not have postoperative hyperglycemia (point of care test \> 10.0 mmol/L).