To Study the Relationship Between Perioperative Hyperglycemia & Postoperative Infections

Abstract

Introduction: Perioperative hyperglycemia is a common metabolic disturbance in surgical patients and is a significant predictor of adverse postoperative outcomes. It impairs immune function, disrupts neutrophil activity, delays wound healing, and increases susceptibility to infections. This effect is observed in both diabetic and non-diabetic individuals, making perioperative glycemic control essential for improving surgical outcomes.

Aim & Objective: To study the relationship between perioperative hyperglycemia and postoperative infections, to estimate the incidence of stress-induced hyperglycemia in previously euglycemic patients, and to compare diabetic and non-diabetic patients regarding perioperative glycemic changes and subsequent bacterial infections.

Materials & Methods: This prospective observational study was conducted in the Department of General Surgery, Johal Multispeciality Hospital, Jalandhar, Punjab, from June 1, 2023 to May 31, 2024. One hundred adult patients undergoing elective or emergency surgery under general or spinal anesthesia were included. Perioperative random blood sugar was assessed preoperatively, intraoperatively, and at 6, 24, and 48 hours postoperatively. Patients were evaluated for postoperative infections and relevant laboratory parameters.

Results: The mean age was 51.79 years, with male predominance (65%). Mean total leukocyte count increased significantly from 9373.43/mm³ preoperatively to 11668.27/mm³ postoperatively (p=0.0305). Hyperglycemic patients had significantly higher random blood sugar values than euglycemic patients at all perioperative stages (p<0.001). Stress hyperglycemia developed in 15.38% of initially euglycemic patients (p<0.001). Preoperative urinary abnormalities were also noted in a small subset. Postoperative infections were markedly more common among preoperative hyperglycemic patients than euglycemic patients.

Conclusion: Perioperative hyperglycemia is a significant modifiable risk factor for postoperative infections. Early identification, close monitoring, and glycemic control may reduce infectious complications and improve surgical outcomes.