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Published on: June 11, 2012
Hyperglycemia after cardiac surgery: improving a quality measure
1Lynda Stoodley is Nurse Practitioner, Cardiothoracic Surgery Program, Torrance Memorial Medical Center, 2841 Lomita Blvd, Ste 310, Torrance, CA 90505 (Lynda.stoodley@tmmc.com). Shu-Fen Wung is Associate Professor, The University of Arizona College of Nursing, Tuscon, Arizona.
Background:
The Surgical Care Improvement Project #4 (SCIP#4) performance measure is used to evaluate achievement of target blood glucose control after cardiac surgery.
Objectives:
The purpose of this study was to identify patient characteristics and outcomes in patients undergoing cardiac surgery who met the SCIP#4 performance measure versus those who did not.
Methods:
A retrospective case-control design was used.
Results:
Preoperative hemoglobin A1C (HbA1C) level and history of diabetes were 2 major risk factors for failing to meet the SCIP#4 measure. A trend toward a longer length of stay was observed, mortality was 3 times more prevalent, and renal failure was 4 times more frequent in patients who did not meet the SCIP#4 quality measure.
Conclusions:
Not meeting the SCIP#4 measure is associated with adverse outcomes. History of diabetes and preoperative HbAIC level should be considered when evaluating strategies for managing postsurgical hyperglycemia.
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