Percentage of patients with perioperative glucose <60mg/dL with administration of glucose or dextrose containing solution or glucose recheck within 90 minutes of original glucose measurement.
The American Diabetes Association uses an outpatient hypoglycemia definition of <70 mg/dL6,7. Severe hypoglycemia in inpatients is considered <40mg/dL6. Acute hypoglycemia in the perioperative period can lead to inadequate supply of glucose to the brain, resulting in seizures, permanent brain damage, and death. In hospitalized diabetic patients, hypoglycemia has been associated with increased length of stay and mortality.5 The risk of negative sequelae related to hypoglycemia is reduced with early recognition and treatment of mild to moderate hypoglycemia (40-69mg/dL)6,8,9. The common signs/symptoms of hypoglycemia are masked by general anesthesia, making vigilance and quick treatment especially important.1 Fasting patients with or without diabetes and diabetic patients treated with oral glycemic agents or insulin are at increased risk of perioperative hypoglycemia.2-3
Perioperative hypoglycemia is a rare event typically caused by the following: 4
*Cases where the ‘Measure End Time’ precedes ‘Measure Start Time’ will be excluded and marked 'invalid'
Preop Time Period (preop start through anesthesia start): The first provider signed into the case.
Intraop Time Period: The provider signed in at the first glucose recheck or first administration of insulin. If neither occurred, then the responsible provider is the one signed in 30 minutes after the high glucose measurement.
Postop Time Period (anesthesia end through PACU End): The last providers signed into the case.
|Brooke Szymanski-Bogart, RN||University of Michigan|
|Genevieve Bell||University of Michigan|
|Nirav Shah, MD||University of Michigan|
|MPOG Quality Committee|
|Date Reviewed||Reviewer||Institution||Summary||QC Vote|
|05/22/2023||Tim Harwood, MD||Wake Forest||
Recheck modified from 90 minutes to 30 minutes.
Lab value modified from 60 mg/dL to 70 mg/dL.
|03/24/2021||Exclusion||Modified to use the Obstetric Type phenotype|