Objectives: To assess the impact of perioperative dysglycaemia on the occurrence of complications due to infections and ischemic events in diabetic patients undergoing surgery at Box Hill Hospital.
Background: There is evidence that peri operative hyperglycaemia impacts on morbidity, length of stay and mortality 1. We sought to audit our compliance with guidelines and demonstrate adverse outcomes following poor perioperative glycaemic control at our hospital
Methods: Diabetic patients who underwent surgery in BHH from the period of February 2015 to April 2015 were randomly retrospectively selected .The patient’s records were assessed for perioperative glycaemic profile and the Charlson comorbidity index (CCI). The impact of hyperglycaemia on the occurrence of post-operative complications of infection, ischemic events, and length of stay was evaluated. The impact of long-term control as represented by the Hba1c was also evaluated.
Results: Of the 54 subjects (52 with type 2 diabetes, mean age 71.3 years), 8 pre-operatively, 6 post operatively and 11 overall had hyperglycaemia > 15 mmol/L (20.4%). Twenty-four had any hyperglycaemia >11 mmol/L (44.4%). Eleven had infectious complications while only 2 had ischemic complications. Any hyperglycaemia >15 mmol/L did not have relationship with infectious complications (Odds ratio (OR) 1.6, 95% confidence interval 0.35-7.33, p=0.55). There was no relationship between perioperative hyperglycaemia and ischemic complications.
Length of stay > 14 days was associated with any hyperglycaemia >15 mmol/L (OR 6.17, 1.6-23.7, p=0.008). There was no relationship between Hba1c and LOS, or infectious or ischemic complications. There was a positive relationship with CCI and LOS, (p= 0.013).
Age was not a predictor of LOS and post op infection.

Conclusions: There was no significant correlation between perioperative hyperglycaemic or Hba1c and post-operative infectious or ischemic complications. Perioperative hyperglycaemia and higher CCI were significantly associated with prolonged length of stay. Perioperative glucose evaluation and management in patients with hyperglycaemia are important quality targets