Diabetes Mellitus (DM) is a highly prevalent comorbidity in patients with morbid obesity. It is still unclear whether a cutoff value of preoperative A1c represents an increased risk for major postoperative complications following Roux-en-Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG).
Retrospective MBSAQIP Participant Use File cohort from 2017-2018 were analyzed to evaluate the relationship between A1c and the 30 days postoperative major complications by Clavien-Dindo classification (III/IV). We used an A1c cutoff of < 7, > =7, and stratified by 1% increment for a total of 11 groups. We used univariate and multivariate logistic regression to analyze the outcome of the complications. All statistical tests were two-sided with a p-value of less than 0.05 considered as a cut-off for statistical significance.
42,181 patients met inclusion criteria, being 20,955 identified with HA1c <7%, and 21,226 patients with HA1c >7%. Utilizing HA1c <7% as a cutoff, we found no consistent statistical significance in the major postoperative complication in patients with HA1c >7%, and when stratified with 1% increment between groups. We also found no significance between groups with risk adjustment for age, sex BMI and DM insulin use.
Extensive analysis of stratified A1C, does not demonstrate a relationship with Clavien-Dindo major complications (III/IV) in large MBSAQIP cohort following Roux-en-Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG).