High Blood Sugar Complicates Surgery, Increases Death

Ivanhoe Newswire
Monday, October 16, 2006; 12:00 AM

By Caroline Penn, Ivanhoe Health Correspondent

ORLANDO, Fla. (Ivanhoe Newswire) -- If you are having hip, knee or heart surgery, make sure to test your blood sugar levels before surgery. It may just save your life.

Patients who have high blood sugar before undergoing surgery run an increased risk of developing blood clots, deep vein thrombosis (DVT) and even pulmonary embolism after surgery. DVT is a blood clot that develops in a deep vein, usually in the lower leg. It can cause pain in the leg and can potentially lead to complications like a pulmonary embolism.

Pulmonary embolism happens when a part of the blood clot breaks off, travels through the bloodstream and lodges in the lungs, blocking blood flow. This can happen hours, or even days, after the formation of a clot in the calf veins. Pulmonary embolism contributes to as many as 200,000 deaths annually in the United States.

A study by Boris Mraovic, M.D., assistant professor of anesthesiology at Jefferson Medical College of Thomas Jefferson University in Philadelphia, reveals a connection between increased blood sugar and a greater risk of dying or medical complications, for hospital patients in intensive or cardiac care units.

Dr. Mraovic and colleagues studied the medical records of about 6,500 patients of hip or knee replacement surgery whose high blood sugar wasn't under control -- greater than 250 milligrams per deciliter -- before surgery. They found 10.5 percent (more than six-times higher than expected) of the patients with high blood sugar developed pulmonary embolism. They report this finding suggests a patient who has very high blood glucose should postpone the surgery until it is lowered to avoid the risk of complications.

"Most of these [hip and knee replacement] patients are on medication for diabetes. We test their sugar two weeks prior to surgery and that gives us time to give them the proper education they need. It also gives them a chance to adjust the dose of medications prior to surgery," Dr. Mraovic told Ivanhoe.