SynthesisKorean journal of anesthesiology2022
The impact of preoperative glycated hemoglobin (HbA1c) on postoperative complications after elective major abdominal surgery: a meta-analysis.
Synthesis in Korean journal of anesthesiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 32 citations in OpenAlex.
- Predicting Risk of Postoperative Pneumonia by a Nomogram in Elderly Patients After Hip Fracture Surgery.Journal of clinical medicine research · 2026Article
- Perioperative predictors of urinary tract infections after percutaneous nephrolithotomy.World journal of nephrology · 2026Article
- Long-term wound morbidity and hernia recurrence in diabetic patients with HbA1c ≥ 8.5% undergoing open transversus abdominis release: a descriptive longitudinal follow-up of a single-center cohort.Hernia : the journal of hernias and abdominal wall surgery · 2026Article
- Continuous glucose monitoring reveals high prevalence of hyperglycaemia in patients prior to pancreatic surgery: A pilot study.Journal of clinical & translational endocrinology · 2026Article
- Article
- Bitter-sweet? The role of glycemic control in breast reduction surgery.BMC surgery · 2026Article
- Impact of Digital Education on MDT Decision-Making in Shortening Hospital Stay for Patients Undergoing Lumbar Disc Herniation Treatment: A Retrospective Study.Journal of multidisciplinary healthcare · 2026Article
- Article
- Multimodal Prehabilitation for Hernia Repair: Linking Metabolic Modulation and Mechanical Methods.Biomedicines · 2025Review
- The Impact of Multidisciplinary Preoperative Optimization Program on Postoperative Outcomes Among Surgical Oncology Patients.Journal of clinical medicine · 2025Article
- Glycated Hemoglobin as a Predictor of Postoperative Delirium in Diabetic Patients Undergoing Noncardiac Surgery: A Retrospective Study.Medicina (Kaunas, Lithuania) · 2025Article
- Optimizing Perioperative Care in Esophageal Surgery: The EUropean PErioperative MEdical Networking (EUPEMEN) Collaborative for Esophagectomy.Diseases (Basel, Switzerland) · 2025Article
- Diabetes Mellitus, Preoperative Glycemic Control and Postoperative Outcomes: A Multi-Ethnic Asian Perspective.Clinical medicine insights. Endocrinology and diabetes · 2025Article
- Glycated Haemoglobin (HbAJournal of clinical medicine · 2024Review
- Article
- Multi-Modal Prehabilitation in Thoracic Surgery: From Basic Concepts to Practical Modalities.Journal of clinical medicine · 2024Review
- Lack of Association of A1C With Postoperative Complications in Children With Type 1 or Type 2 Diabetes.Clinical diabetes : a publication of the American Diabetes Association · 2024Article
- [Position statement: surgery and diabetes mellitus (Update 2023)].Wiener klinische Wochenschrift · 2023Article
- Prehabilitation in Patients before Major Surgery: A Review Article.JNMA; journal of the Nepal Medical Association · 2022Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiabetes is a risk factor for postoperative complications. Previous meta-analyses have shown that elevated glycated hemoglobin (HbA1c) levels are associated with postoperative complications in various surgical populations. However, this is the first meta-analysis to investigate the association between preoperative HbA1c levels and postoperative complications in patients undergoing elective major abdominal surgery.
methodsPRISMA guidelines were adhered to for this study. Six databases were searched up to April 1, 2020. Primary studies investigating the effect of HbA1c levels on postoperative complications after elective major abdominal surgery were included. Risk of bias and quality of evidence assessments were performed. Data were pooled using a random effects model. Meta-regression was performed to evaluate different HbA1c cut-off values.
resultsTwelve observational studies (25,036 patients) were included. Most studies received a 'good' and 'moderate quality' score using the NOS and GRADE, respectively. Patients with a high HbA1c had a greater risk of anastomotic leaks (odds ratio [OR]: 2.80, 95% CI [1.63, 4.83], P < 0.001), wound infections (OR: 1.21, 95% CI [1.08, 1.36], P = 0.001), major complications defined as Clavien-Dindo [CD] 3-5 (OR: 2.16, 95% CI [1.54, 3.01], P < 0.001), and overall complications defined as CD 1-5 (OR: 2.12, 95% CI [1.48, 3.04], P < 0.001).
conclusionsAn HbA1c between 6% and 7% is associated with higher risks of anastomotic leaks, wound infections, major complications, and overall postoperative complications. Therefore, guidelines with an HbA1c threshold > 7% may be putting pre-optimized patients at risk. Future randomized controlled trials are needed to explore causation before policy changes are made.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.