Abstract

Aim: Prediction of post operative complications from pre operative HbA1c levels & its relation on post op. morbidity & overall recovery of patient after major  gastro-intestinal surgery.

Materials and Methods: A total no. of 60 patients  who were planned for major GI  surgery were taken into study  and were divided into two groups as per pre- op HbA1c  level (<6% or >6%).The clinical data  & final results were  analysed in relation to pre op. and post op. hyperglycemia.

Observation: It is observed that post-op. day1 FBS is raised in all patients, however post-op day 1 hyperglycemia is present in 60% of patients in HbA1c> 6% and 22.5% in patients in HbA1c < 6%. The post-op. complications occur more i.e. 65% in HbA1c >6% and 20% in   HbA1c <6%. The infectious complication is more i.e. 50% in HbA1c >6% and 5% in HbA1c <6%. The post-op. recovery i.e. early bowel movement, early oral feeding   are also delayed in HbA1c >6% group. The post-op. hospital   staying is also   more in this   group. The   post-op.  CPR response is also significantly raised in HbA1c > 6% group.

Conclusion: That pre operative HbA1c may be used to identify patients at higher risk of poor post-op.  glycemic control and prediction of post- op. complications, recovery & morbidity after major gastro-intestinal surgery.

Keywords:  Hyperglycemia, HbA1c, Gastro intestinal surgery.