Blood glucose level on postoperative day 1 is predictive of adverse outcomes after cardiovascular surgery.

Details

Serval ID
serval:BIB_2FE554BFF29E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Blood glucose level on postoperative day 1 is predictive of adverse outcomes after cardiovascular surgery.
Journal
Diabetes and Metabolism
Author(s)
Frioud A., Comte-Perret S., Nguyen S., Berger M.M., Ruchat P., Ruiz J.
ISSN
1262-3636
Publication state
Published
Issued date
2010
Volume
36
Number
1
Pages
36-42
Language
english
Abstract
AIM: Hyperglycaemia is now a recognized predictive factor of morbidity and mortality after coronary artery bypass grafting (CABG). For this reason, we aimed to evaluate the postoperative management of glucose control in patients undergoing cardiovascular surgery, and to assess the impact of glucose levels on in-hospital mortality and morbidity. METHODS: This was a retrospective study investigating the association between postoperative blood glucose and outcomes, including death, post-surgical complications, and length of stay in the intensive care unit (ICU) and in hospital. RESULTS: A total of 642 consecutive patients were enrolled into the study after cardiovascular surgery (CABG, carotid endarterectomy and bypass in the lower limbs). Patients' mean age was 68+/-10 years, and 74% were male. In-hospital mortality was 5% in diabetic patients vs 2% in non-diabetic patients (OR: 1.66, P=0.076). Having blood glucose levels in the upper quartile range (> or =8.8 mmol/L) on postoperative day 1 was independently associated with death (OR: 10.16, P=0.0002), infectious complications (OR: 1.76, P=0.04) and prolonged ICU stay (OR: 3.10, P<0.0001). Patients presenting with three or more hypoglycaemic episodes (<4.1 mmol/L) had increased rates of mortality (OR: 9.08, P<0.0001) and complications (OR: 8.57, P<0.0001). CONCLUSION: Glucose levels greater than 8.8 mmol/L on postoperative day 1 and having three or more hypoglycaemic episodes in the postoperative period were predictive of mortality and morbidity among patients undergoing cardiovascular surgery. This suggests that a multidisciplinary approach may be able to achieve better postoperative blood glucose control.
Keywords
Diabetes, Hyperglycaemia, Hypoglycaemia, Mortality, Coronary Artery Bypass Grafting, Surgery, Post-Surgery Monitoring, Intensive Insulin Therapy, Critically-Ill Patients, Perioperative Glycemic Control, Diabetic-Patients, Infectious Complications, Carotid-Endarterectomy, Wound-Infection, Bypass Surgery, Coronary, Mortality
Pubmed
Web of science
Create date
25/03/2010 10:53
Last modification date
20/08/2019 13:14
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