Abstract:
Introduction: Surgical procedures cause major alterations in hemodynamic,
metabolic-endocrine, and immune responses. Postoperative hyperglycemia related to
surgical stress is one of its consequences and that needs to be controlled, otherwise it
might result in a wide range of complications. However, there is a dearth of evidence
on the magnitude of postoperative hyperglycemia and its associated factors among
adult postoperative nondiabetic patients underwent major surgery in the study area,
even in Ethiopia.
Objective: This study aimed to assess postoperative hyperglycemia and associated
factors among nondiabetic adult patients who underwent major surgery at the
University of Gondar Comprehensive Specialized Hospital, Gondar, Northwest
Ethiopia, 2020
Methods: A hospital-based cross-sectional study was conducted among 422
nondiabetic adult patients underwent major surgery from March 15 to June 15, 2020.
Postoperative patients were selected using systematic random sampling. Face-to-face
interview, chart review and capillary blood glucose level measurement were used to
collect the data. Descriptive statistics were used to summarize the study variables.
Binary logistic regression model was fitted to identify associated factors. Odds ratio
with the 95% confidence interval was calculated to show the strength of association.
Finally, variables with a P-value < 0.05 were considered statistically significant.
Results: A total of 413 postoperative nondiabetic adult patients were participated in
the study. The overall prevalence of postoperative hyperglycemia (>140mg/dl) was
15.74% (95% CI; 12.21, 19.27). Being aged > 60years [AOR=3.30(95%CI: 1.25,
8.71)], being employed in public or private sectors [AOR=2.87(95%CI: 1.05, 7.84)],
having gynecologic surgery [AOR=3.7(95%CI: 1.49, 9.23)] and orthopedics surgery
[AOR=5.07 (95%CI: 2.10, 12.25)] were positively associated with postoperative
hyperglycemia. Whereas, measuring blood glucose within 25-48hrs after surgery
[AOR=0.34 (95%CI:0.16,0.75)], and taking IV fluid >5000ml [AOR=0.29(95%CI: 0.11,
0.74)] were negatively associated with postoperative hyperglycemia.
Conclusion: The prevalence of postoperative hyperglycemia among non-diabetic
patients who underwent major surgery was considerably high. Patient’s age,
occupation, type of surgical procedure, time after surgery and amount of IV fluid taken
were significantly associated with postoperative hyperglycemia. Hence, measuring
perioperative blood glucose level at regular interval, especially for older and patients
undergoing orthopedic and gynecologic surgical procedure is advisable to reduce the
postoperative hyperglycemic-related complications.
Keywords: Adult, Ethiopia, Major surgery; non-diabetic patients, postoperative
hyperglycemia
