Development and Implementation of a Perioperative Blood Glucose Monitoring Protocol for Patients Undergoing Spinal Surgery.

Journal Article (Journal Article)

PURPOSE: Stress-induced hyperglycemia during the perioperative period is associated with adverse outcomes after spinal surgery, which increases both patient-related burden and hospital costs. This quality improvement project describes the development and implementation of a perioperative blood glucose monitoring protocol for patients undergoing spinal surgery. DESIGN: An evidence-based perioperative blood glucose monitoring protocol was developed by a multidisciplinary committee of specialists in endocrinology and anesthesiology with utilization of the American Diabetes Association diabetes screening criteria. METHODS: The protocol was implemented in the perioperative areas of a regional hospital in the Southeastern United States. The project sample included patients with and without a prior diagnosis of diabetes who met protocol inclusion criteria during a 3-month implementation period. FINDINGS: Preoperative glycated hemoglobin (HbA1c) testing identified more than 54% of previously undiagnosed patients with levels consistent with either prediabetes or diabetes according to the American Diabetes Association criteria for diagnosis. Patients with diabetes and those without diabetes experienced a perioperative increase in blood glucose with levels remaining elevated above preoperative baseline through postoperative day 1. CONCLUSIONS: A perioperative blood glucose monitoring protocol enables preoperative identification of patients with undiagnosed prediabetes and diabetes, allowing for optimization before elective surgery and establishment of appropriate postoperative follow-up care. In addition, a blood glucose monitoring protocol increases the detection of perioperative hyperglycemia and may lead to a reduction in postoperative complications after spinal surgery.

Full Text

Duke Authors

Cited Authors

  • Wainwright, CL; Setji, TL; Sata, SD; Lamb, SW; Goode, V

Published Date

  • April 2020

Published In

Volume / Issue

  • 35 / 2

Start / End Page

  • 135 - 139

PubMed ID

  • 31787554

Electronic International Standard Serial Number (EISSN)

  • 1532-8473

Digital Object Identifier (DOI)

  • 10.1016/j.jopan.2019.09.006


  • eng

Conference Location

  • United States