Perioperative Glycemic Control and Outcomes in Cardiac Surgery: A Retrospective Cohort Study

Area of Science:

• Cardiology
• Endocrinology
• Critical Care Medicine

Background:

• Perioperative hyperglycemia is a common stress response in cardiac surgery patients.
• Both hyperglycemia and hypoglycemia can lead to adverse outcomes, but optimal glycemic targets remain unclear.
• This study investigates the link between perioperative glucose control and patient outcomes.

Purpose of the Study:

• To evaluate the association between perioperative glucose levels and postoperative infection.
• To assess the relationship between perioperative glucose levels and in-hospital mortality in cardiac surgery patients.
• To determine the impact of blood glucose target (BGT) compliance on outcomes.

Main Methods:

• Retrospective analysis of 157 adult patients undergoing cardiac surgery.
• Perioperative glycemic exposure monitored from anesthesia induction to discharge or death.
• Blood glucose target (BGT) compliance defined as ≥70% of measurements within 70-180 mg/dL.

Main Results:

• Postoperative infection occurred in 59.9% and in-hospital mortality in 8.9% of patients.
• BGT compliance was achieved in 78.3% of patients, with 31.8% experiencing hypoglycemia and 82.8% hyperglycemia.
• BGT compliance was associated with lower mortality (OR 0.10), while hyperglycemia was linked to increased infection risk (OR 3.77).

Conclusions:

• Perioperative glycemic patterns significantly impact outcomes after cardiac surgery.
• Compliance with a moderate BGT (70-180 mg/dL) correlates with reduced in-hospital mortality.
• Hyperglycemia is an independent risk factor for postoperative infection, warranting further investigation in prospective studies.