Beena Bansal1, Pravin Carvalho2, Yatin Mehta3, Jitender Yadav4, Prateek Sharma5, Ambrish Mithal6, Naresh Trehan7. 1. Division of Endocrinology and Diabetes, Medanta, The Medicity. Electronic address: beenabansal1975@yahoo.co.in. 2. Gida, Bengaluru. Electronic address: pravincar@gmail.com. 3. Institute of Critical Care & Anaesthesiology, Medanta, the Medicity. Electronic address: yatin.mehta@medanta.org. 4. Division of Endocrinology and Diabetes, Medanta, The Medicity. Electronic address: jitenderyadav82@gmail.com. 5. Cardiac Anesthesia, Medanta, the Medicity, Gurgaon. Electronic address: drprateek2412@gmail.com. 6. Division of Endocrinology and Diabetes, Medanta, The Medicity. Electronic address: ambrish.mithal@medanta.org. 7. Heart Institute- Division of Cardio Thoracic & Vascular Surgery, Medanta, the Medicity. Electronic address: naresh.trehan@medanta.org.
Abstract
INTRODUCTION: The prognostic significance of acute glycemic variability (GV) after cardiac surgery is not known. This study was therefore planned to analyze the independent prognostic value of GV after cardiac surgery. MATERIALS AND METHODS: This is a single center prospective observational study in 870 consecutive cardiac surgery patients over a 3-month period at a tertiary care institute in India. RESULTS: In linear regression analysis, GV was a significant predictor of length of stay in intensive care unit (LOS-ICU) (beta 0.102, p=0.007) and rise in creatinine after surgery (beta 0.229, p<0.001). Mean POC-BG was a significant positive predictor of length of stay in hospital (LOS-hospital) (beta 0.1, p=0.004). In multivariable logistic regression analysis, GV predicted prolonged LOS-ICU (p=0.006, OR 1.016) and acute kidney injury (p<0.001, OR 1.034). CONCLUSION: This study showed that GV, as measured by standard deviation, was a predictor of LOS-ICU, rise in creatinine and AKI after cardiac surgery. GV is therefore a new dimension in postoperative glycemic management in cardiac surgery patients, which needs to be explored.
INTRODUCTION: The prognostic significance of acute glycemic variability (GV) after cardiac surgery is not known. This study was therefore planned to analyze the independent prognostic value of GV after cardiac surgery. MATERIALS AND METHODS: This is a single center prospective observational study in 870 consecutive cardiac surgery patients over a 3-month period at a tertiary care institute in India. RESULTS: In linear regression analysis, GV was a significant predictor of length of stay in intensive care unit (LOS-ICU) (beta 0.102, p=0.007) and rise in creatinine after surgery (beta 0.229, p<0.001). Mean POC-BG was a significant positive predictor of length of stay in hospital (LOS-hospital) (beta 0.1, p=0.004). In multivariable logistic regression analysis, GV predicted prolonged LOS-ICU (p=0.006, OR 1.016) and acute kidney injury (p<0.001, OR 1.034). CONCLUSION: This study showed that GV, as measured by standard deviation, was a predictor of LOS-ICU, rise in creatinine and AKI after cardiac surgery. GV is therefore a new dimension in postoperative glycemic management in cardiac surgery patients, which needs to be explored.
Authors: Mitra K Nadim; Lui G Forni; Azra Bihorac; Charles Hobson; Jay L Koyner; Andrew Shaw; George J Arnaoutakis; Xiaoqiang Ding; Daniel T Engelman; Hrvoje Gasparovic; Vladimir Gasparovic; Charles A Herzog; Kianoush Kashani; Nevin Katz; Kathleen D Liu; Ravindra L Mehta; Marlies Ostermann; Neesh Pannu; Peter Pickkers; Susanna Price; Zaccaria Ricci; Jeffrey B Rich; Lokeswara R Sajja; Fred A Weaver; Alexander Zarbock; Claudio Ronco; John A Kellum Journal: J Am Heart Assoc Date: 2018-06-01 Impact factor: 5.501