Review: The relationship of hemoglobin A1c to postoperative surgical risk with an emphasis on joint replacement surgery

Lizette F. Lopez, Peter D. Reaven, Sherman M. Harman

Research output: Contribution to journalReview article

5 Scopus citations

Abstract

Patients with diabetes mellitus are known to have a high risk of postoperative complications, including infections, impaired wound healing, cardiovascular events, venous thromboembolism, and mortality. Because hyperglycemia has been thought to mediate this risk, there is a clinical propensity for improving glycemic control, as assessed by hemoglobin A1c (HbA1c) level, prior to proceeding with elective surgery, particularly joint replacement surgery. However, it is not established whether chronic poor glycemic control, indicated by elevated HbA1c levels, predicts increased risk of postoperative complications. The benefit of improving glycemic control must be weighed against risks of delaying necessary elective surgery, such as joint replacement surgery, which risks may include negative impact on long-term glycemic control. Thus, we review the current evidence to determine the relationship between HbA1c and postoperative surgical risk, especially on joint replacement surgery.

Original languageEnglish (US)
Pages (from-to)1710-1718
Number of pages9
JournalJournal of Diabetes and its Complications
Volume31
Issue number12
DOIs
StatePublished - Dec 2017
Externally publishedYes

Keywords

  • Diabetes
  • Hemoglobin A1c
  • Joint surgery
  • Postoperative
  • Surgical risk

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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