Quality Gaps in Screening and Monitoring for Postoperative Hyperglycemia in a Canadian Hospital

Completed

• Conditions: Diabetes Mellitus; Hyperglycemia; Surgery
• Interventions: Other: Exposure - postoperative hyperglycemia

• Registration Number: NCT04679025
• Lead Sponsor: University of Calgary

Brief Summary

Patients with and without diabetes who have postoperative hyperglycemia have worse outcomes than patients with in-target blood sugars. Previous quality improvement work suggests numerous barriers and clinical inertia may contribute to quality gaps in glycemic management for surgical patients. Using a framework for perioperative glycemic management, we sought to measure quality gaps in perioperative glycemic care.

This cross-sectional study used administrative data to measure the proportion of surgical patients with and without known diabetes who underwent preoperative hemoglobin A1c measurement, postoperative point-of-care testing for glucose (POCT), had hyperglycemia, and received basal bolus insulin regimens for treatment. We performed an exploratory analysis comparing length of stay (LOS) in patients with and without diabetes who had and did not have postoperative hyperglycemia.

Detailed Description

Not available

Study Timeline

• Study Start: 2019-04-01
• Primary Completion: 2020-03-31
• Study Completion: 2020-03-31
• Status Verified: 2020-12
• Study First Submitted: 2020-12-11
• Study First Submitted QC: 2020-12-16
• Last Update Submitted: 2020-12-16
• Study First Posted: 2020-12-22
• Last Update Posted: 2020-12-22

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 7633

Inclusion Criteria

• Underwent inpatient surgical procedure at the Foothills Medical Centre between Apr 1 2019 and March 31 2020
• Stayed in hospital for more than 24-hours after surgery

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Exclusion Criteria

• Younger than 18 years of age

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Diabetes with postoperative hyperglycemia	Exposure - postoperative hyperglycemia	Patients with known diabetes (Discharge Abstract Database or hemoglobin A1c \> 6.5%) who had postoperative hyperglycemia (point of care test \> 10.0 mmol/L).
No diabetes with postoperative hyperglycemia	Exposure - postoperative hyperglycemia	Patients without known diabetes (Discharge Abstract Database or hemoglobin A1c \> 6.5%) who had postoperative hyperglycemia (point of care test \> 10.0 mmol/L).

Primary Outcome Measures

Name	Time	Method
Proportion of patients who have hyperglycemia	24-hours after surgery	blood or capillary glucose \> 10 mmol/L
Number of point of care blood glucose measurements in 24-hours after surgery	24-hours post surgery

Secondary Outcome Measures

Name	Time	Method
Proportion of patients who have moderate hyperglycemia	24-hours after surgery	blood or capillary glucose 14.0-17.9 mmol/L
Proportion of patients who have severe hyperglycemia	24-hours after surgery	blood or capillary glucose \> 18.0 mmol/L
Hospital Length of stay	Until study completion (up to one year from surgical procedure)	Hospital length of stay (days)

Trial Locations

Locations (1)

Foothills Medical Centre; 🇨🇦 Calgary, Alberta, Canada