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

NCT04679025 | Completed

• 1 other identifier: HREBA.CC-19-0157
• Study Type: observational
• Target: 7,633
• Locations: 1 country
• Sites: 1

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.

Conditions

Diabetes Mellitus; Surgery; Hyperglycemia

Outcome Measures

Primary Outcomes (2)

• Number of point of care blood glucose measurements in 24-hours after surgery

  24-hours post surgery

• Proportion of patients who have hyperglycemia

  blood or capillary glucose \> 10 mmol/L

  24-hours after surgery

Secondary Outcomes (3)

• Proportion of patients who have moderate hyperglycemia

  24-hours after surgery

• Proportion of patients who have severe hyperglycemia

  24-hours after surgery

• Hospital Length of stay

  Until study completion (up to one year from surgical procedure)

Study Arms (4)

Diabetes with 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).

Other: Exposure - postoperative hyperglycemia

Diabetes without postoperative hyperglycemia

Patients with known diabetes (Discharge Abstract Database or hemoglobin A1c \> 6.5%) who did not have postoperative hyperglycemia (point of care test \> 10.0 mmol/L).

No diabetes with 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).

Other: Exposure - postoperative hyperglycemia

No diabetes and no postoperative hyperglycemia

Patients without known diabetes (Discharge Abstract Database or hemoglobin A1c \> 6.5%) who did not have postoperative hyperglycemia (point of care test \> 10.0 mmol/L).

Interventions

Exposure - postoperative hyperglycemia OTHER

Postoperative hyperglycemia (blood or capillary glucose \> 10.0 mmol/L) within 72 hours of a surgical procedure

Diabetes with postoperative hyperglycemia; No diabetes with postoperative hyperglycemia

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients undergoing a surgical procedure at the Foothills Medical Centre who were admitted for at least 24-hours.

You may qualify if:

• 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

You may not qualify if:

• Younger than 18 years of age

Sponsors & Collaborators

• University of Calgary: lead

Study Sites (1)

Foothills Medical Centre

Calgary, Alberta, T2N 4T9, Canada

Location

MeSH Terms

Conditions

Diabetes Mellitus; Hyperglycemia

Condition Hierarchy (Ancestors)

Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Clinical Assistant Professor

Study Record Dates

• First Submitted: December 11, 2020
• First Posted: December 22, 2020
• Study Start: April 1, 2019
• Primary Completion: March 31, 2020
• Study Completion: March 31, 2020
• Last Updated: December 22, 2020

Record last verified: 2020-12

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP
• Time Frame: Present for five years after study completion (March 31 2020).
• Access Criteria: Email shannon.ruzycki@ucalgary.ca

Locations

CA (1)