Establishing a recommended duration of blood glucose monitoring in nondiabetic patients following orthopaedic surgery. Issue 8 (29th October 2021)

• Record Type: Journal Article
• Authors: O'Brien, Todd M.; Hosseinzadeh, Shayan; Chen, Antonia F.; Verrier, Kimberly I.; Melnic, Christopher M.; Humphrey, Tyler J.; Bedair, Hany S.
• Is Part Of: Journal of orthopaedic research. Volume 40:Issue 8(2022)
• Page Start: 1926
• Page End: 1931
• Publication Date: 2021-10-29
• Subjects: blood glucose monitoring -- care protocol -- diabetes -- inpatient -- patient outcomes; Orthopedics -- Periodicals; Musculoskeletal system -- Periodicals; 616.7
• DOI: 10.1002/jor.25202
• Languages: English
• ISSNs: 0736-0266

Abstract

Abstract: Previous studies have demonstrated that blood glucose (BG) levels should be monitored for at least 1 week after orthopaedic surgery in diabetic patients, but no study has determined how long nondiabetic patients should be monitored. As postoperative elevations in BG have deleterious effects, determining a duration for monitoring the BG of nondiabetic patients after major orthopaedic surgery is needed to detect hyperglycemic events, create comprehensive protocols for nondiabetic orthopaedic patients, and reduce adverse outcomes. A retrospective study was conducted including consecutive patients who underwent a major orthopaedic surgery at a community hospital. A BG level of 150 mg/dl was the cutoff used to define hyperglycemia according to our institutional guidelines. A χ 2, analysis of variance, and subgroup analysis were performed separately. Greater than 67% of nondiabetic patients experienced a high BG level (>150 mg/dl) after surgery. We found that nondiabetic patients reached their postoperative maximum BG level at 20 h, which was sooner compared to diabetic patients. We discovered more than 92% of nondiabetic patients reached a maximum BG levels within the first 72 h of hospitalization, while the BG levels after this period were found to be within normal limits in greater than 87% of cases. We propose that BG management be instituted in nondiabetics from the preoperative period to 72 h after surgery, including patients who are same‐day discharges. There may not be a need to continue inpatient BG monitoring beyond the first 72 h for nondiabetic hospitalized patients with extended hospitalizations.