High Blood sugar tied to complications and secondary procedure after surgery for torsional ankle fractures in diabetic patients: Study

A recent retrospective study investigated the correlation between elevated blood glucose levels and postoperative complications in diabetic patients who underwent surgical treatment for torsional ankle fractures. The findings of this study published in the Foot and Ankle International journal highlighted a significant association between high HbA1c levels and adverse outcomes following surgery.

This study spanned from January 2017 to December 2021 involved a thorough examination of consecutive diabetic patients who underwent surgical intervention for ankle injuries. The patients were categorized into two groups based on their HbA1c levels, where one group had patients with levels above 7.0% and were classified as the high-HbA1c group, while the other group had patients with levels equal to or below 7.0% that constituted the low-HbA1c group. A intense propensity score match was executed to reduce the potential confounding factors.

Among the matched cohort of 238 patients that comprised 119 individuals in each group, strong disparities in postoperative outcomes were observed. The patients with high HbA1c levels expressed a significantly higher incidence of complications (31.1% vs. 18.5%) and unplanned secondary procedures (22.7% vs. 8.4%) when compared to their counterparts with lower HbA1c levels.

The multivariate analyses further underlined the adverse impact of increased HbA1c levels on surgical outcomes. The patients with high HbA1c levels were found to be at substantially greater risk of undergoing any complications, superficial and deep infections, as well as requiring unplanned secondary operations, even after accounting for potential confounders.

The implications of these findings highlight the importance of glycemic control in diabetic patients who undergo surgical treatment for ankle fractures. The multivariate linear regression analyses revealed a direct correlation between high HbA1c levels and both the frequency of complications and the necessity for secondary procedures which highlights the need for vigilant preoperative glycemic management.

The outcomes of this study emphasized the potential for optimizing patient outcomes through targeted interventions to control blood glucose levels prior to surgery.  This research observed that meticulous preoperative assessment and management of glycemic control could reduce the risk of postoperative complications and enhance the overall success of surgical interventions for ankle fractures in diabetic patients. Overall, the study provides strong evidence of the detrimental impact of high blood glucose levels on the postoperative course of diabetic patients undergoing surgical treatment for torsional ankle fractures.

Source:

Chen, D., Liu, S., Liu, P., & Song, W. (2024). Effect of Elevated Blood Glucose on Postoperative Complications Among Diabetic Patients After Surgical Treatment of Torsional Ankle Fracture. In Foot & Ankle International. SAGE Publications. https://doi.org/10.1177/10711007241250005