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

Diabetes Mellitus Clinical Trial

Official title:

Quality Gaps in Screening and Monitoring for Postoperative Hyperglycemia in a Canadian Hospital: A Cross-sectional, Exploratory Study

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04679025
• Other study ID #: HREBA.CC-19-0157
• Status: Completed
• Start date: April 1, 2019
• Est. completion date: March 31, 2020

Study information

• Verified date: December 2020
• Source: University of Calgary
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial 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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 7633
• Est. completion date: March 31, 2020
• Est. primary completion date: March 31, 2020
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• 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

Exclusion Criteria:

• Younger than 18 years of age

Related Conditions & MeSH terms

• Diabetes Mellitus
• Hyperglycemia
• Surgery

Intervention

Other:
• Exposure - postoperative hyperglycemia
Postoperative hyperglycemia (blood or capillary glucose > 10.0 mmol/L) within 72 hours of a surgical procedure

Locations

Country	Name	City	State
Canada	Foothills Medical Centre	Calgary	Alberta

Sponsors (1)

Lead Sponsor	Collaborator
University of Calgary

Country where clinical trial is conducted

Canada, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of point of care blood glucose measurements in 24-hours after surgery		24-hours post surgery
Primary	Proportion of patients who have hyperglycemia	blood or capillary glucose > 10 mmol/L	24-hours after surgery
Secondary	Proportion of patients who have moderate hyperglycemia	blood or capillary glucose 14.0-17.9 mmol/L	24-hours after surgery
Secondary	Proportion of patients who have severe hyperglycemia	blood or capillary glucose > 18.0 mmol/L	24-hours after surgery
Secondary	Hospital Length of stay	Hospital length of stay (days)	Until study completion (up to one year from surgical procedure)