Type 2 Diabetes Mellitus and Preoperative HbA1c Level Have no Consequence on Outcomes after Laparoscopic Sleeve Gastrectomy—a Cohort Study

Abstract

Introduction: Available clinical data on the influence of baseline HbA1c postoperative morbidity and readmission after laparoscopic sleeve gastrectomy is scarce. This prompted us to conduct a multicenter retrospective study evaluating the influence of chronic hyperglycemia on postoperative course among patients undergoing laparoscopic sleeve gastrectomy (SG). We aimed to investigate the influence of baseline HbA1c levels on postoperative outcomes in patients after SG. Material and Methods: We conducted a multicenter retrospective cohort study of consecutive patients who underwent SG from March 2017 to March 2018 in seven referral centers for bariatric surgery. Exclusion criteria were revision surgeries, different bariatric interventions, SG combined with other procedures, and lack of necessary data. Patients were divided into three groups depending on their preoperative glycated hemoglobin level (HbA1c) < 5.7%, 5.7–6.4%, and ≥ 6.5%. Primary endpoints were influence of HbA1c on early and late postoperative morbidity, impact on prolonged length of hospital stay (LOS), and readmission rate. Results: The HbA1c < 5.7% group comprised 842 (49%) patients, HbA1c 5.7–6.4% comprised 587 (34%), and HbA1c ≥ 6.5% comprised 289 (17%). Overall morbidity was 6.23%; this did not differ among groups (p = 0.571). Three patients died postoperatively. Late postoperative morbidity was comparable among groups (p = 0.312). The ratio of prolonged LOS and readmission did not differ among groups (p = 0.363 and 0.571). ROC analysis revealed that HbA1c > 7.3% increased OR for hospital readmission (p = 0.007). Conclusion: Preoperative HbA1c does not affect postoperative morbidity and prolonged LOS after SG. Patients with HbA1c > 7.3% have an increased chance of hospital readmission.