Careful control of blood sugar after surgery helps reduce the risk of post-surgical… (Francine Orr/Los Angeles…)
What can doctors and patients do to reduce the risk of developing serious infections after surgery? It surely can’t hurt to make sure the operating room is spic and span. Requiring physicians, nurses and medical technicians to wash their hands before treating post-operative patients probably isn’t a bad idea either.
But a study published in Tuesday’s edition of Archives of General Surgery suggests another measure: Carefully control the patient’s blood sugar after surgery.
It’s already well known that patients with diabetes are more susceptible to infections after surgery. In addition, surgical patients in many ICUs have their blood sugar closely monitored, to reduce the risk of surgical site infections.
A group of researchers from Albany Medical College in New York tried to get more specific about the link between blood sugar and post-operative infections. They examined the medical records of 1,561 patients who were operated on at Albany Medical Center over a 2 1/2-year period and looked to see whether high blood sugar was linked to a higher rate of infection, regardless of whether the patient was diabetic.
For two groups of patients, the answer was yes.
Among general-surgery patients, those with blood glucose of 110 mg/dL or less were the least likely to develop infections, with an infection rate of 1.8%. For those with blood glucose between 111 mg/dL and 140 mg/dL, the risk was 3.6 times greater. Patients with blood sugar even higher than that had a 12 times greater risk of infection, according to the study.
Among patients who had colorectal surgery, those whose post-operative blood sugar was above 140 mg/dL were three times more likely to get an infection than those with blood glucose of 140 mg/DL or less (20.6% vs. 7.6%).
The researchers did not find any link between blood glucose and infection rates in patients who had vascular surgery.
How might blood sugar be related to infection susceptibility? The researchers explain several possible mechanisms, including the fact that having high blood sugar hurts the immune system by making it more difficult for cells to remove pathogens.
You can read a summary of the study here.
-- Karen Kaplan / Los Angeles Times