• S M Lamloum, L A Mobasher, A H Karar, L Basiony, T H Abdallah, A I Al-Saleh, and N A Al-Shamali.
• Department of Laboratory Medicine, Al Razi Hospital, Ministry of Health, Safat 4235, Kuwait. saharlamlom@yahoo.com
• Med Princ Pract. 2009 Jan 1; 18 (6): 447452447-52.

ObjectiveTo study the relationship between postoperative infectious complications and glycemic control for diabetic patients in an orthopedic hospital in Kuwait.Subjects And MethodsPatients who underwent surgical orthopedic procedures between 2006 and 2007 were identified to provide demographic and clinical informations including age, gender, type of surgery, length of operation, HbA(1c) values, nature of specimens and species of the isolated pathogens. HbA(1c) <7% was used as the breaking point for diabetic control and occurrence of postoperative complications. Primary outcomes with infectious complications, including urinary tract infection, surgical site infection (SSI), lower respiratory tract infection and sepsis with different isolated pathogens were identified at least 48 h postoperatively.ResultsOf 318 diabetic patients who underwent surgical operations, 90 (28.3%) developed postoperative complications; HbA(1c) <7% was significantly associated with decreased infectious complications with an adjusted odds ratio of 2.51 (95% confidence interval, 1.20-2.89). Regarding types of complications, urinary tract infectious complications were significantly higher among those patients with HbA(1c) > or =7% (p < 0.0001), while other complications (SSI, lower respiratory tract infection and sepsis) showed nonsignificant differences (p > 0.05).ConclusionsOur study confirmed a close association between preoperative glucose control indicated by HbA(1c) levels <7% and a decreased risk of postoperative infectious complications. Ideally, preoperative blood sugar should be controlled prior to elective surgery. Prophylaxis by antibiotics with preoperative patient preparation, proficient surgical technique and postoperative wound care is recommended for uncontrolled diabetics subjected to surgery.Copyright 2009 S. Karger AG, Basel.

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