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

Détails

ID Serval
serval:BIB_2FE554BFF29E
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Blood glucose level on postoperative day 1 is predictive of adverse outcomes after cardiovascular surgery.
Périodique
Diabetes and Metabolism
Auteur(s)
Frioud A., Comte-Perret S., Nguyen S., Berger M.M., Ruchat P., Ruiz J.
ISSN
1262-3636
Statut éditorial
Publié
Date de publication
2010
Volume
36
Numéro
1
Pages
36-42
Langue
anglais
Résumé
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.
Mots-clé
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
Création de la notice
25/03/2010 10:53
Dernière modification de la notice
20/08/2019 13:14
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