Glycated Hemoglobin and Risk of Sternal Wound Infection After Isolated Coronary Surgery
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Glycated Hemoglobin and Risk of Sternal Wound Infection After Isolated Coronary Surgery. / Gatti, Giuseppe; Perrotti, Andrea; Reichart, Daniel; Maschietto, Luca; Onorati, Francesco; Chocron, Sidney; Dalén, Magnus; Svenarud, Peter; Faggian, Giuseppe; Santarpino, Giuseppe; Fischlein, Theodor; Pappalardo, Aniello; Maselli, Daniele; Dominici, Carmelo; Nardella, Saverio; Rubino, Antonino S; De Feo, Marisa; Santini, Francesco; Nicolini, Francesco; Gherli, Riccardo; Mariscalco, Giovanni; Tauriainen, Tuomas; Kinnunen, Eeva-Maija; Ruggieri, Vito G; Saccocci, Matteo; Biancari, Fausto.
in: CIRC J, Jahrgang 81, Nr. 1, 22.12.2016, S. 36-43.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Glycated Hemoglobin and Risk of Sternal Wound Infection After Isolated Coronary Surgery
AU - Gatti, Giuseppe
AU - Perrotti, Andrea
AU - Reichart, Daniel
AU - Maschietto, Luca
AU - Onorati, Francesco
AU - Chocron, Sidney
AU - Dalén, Magnus
AU - Svenarud, Peter
AU - Faggian, Giuseppe
AU - Santarpino, Giuseppe
AU - Fischlein, Theodor
AU - Pappalardo, Aniello
AU - Maselli, Daniele
AU - Dominici, Carmelo
AU - Nardella, Saverio
AU - Rubino, Antonino S
AU - De Feo, Marisa
AU - Santini, Francesco
AU - Nicolini, Francesco
AU - Gherli, Riccardo
AU - Mariscalco, Giovanni
AU - Tauriainen, Tuomas
AU - Kinnunen, Eeva-Maija
AU - Ruggieri, Vito G
AU - Saccocci, Matteo
AU - Biancari, Fausto
PY - 2016/12/22
Y1 - 2016/12/22
N2 - BACKGROUND: Glycated hemoglobin (HbA1c) is a suspected risk factor for sternal wound infection (SWI) after CABG.Methods and Results:Data on preoperative HbA1c and SWI were available in 2,130 patients undergoing isolated CABG from the prospective E-CABG registry. SWI occurred in 114 (5.4%). Baseline HbA1c was significantly higher in patients with SWI (mean, 54±17 vs. 45±13 mmol/mol, P<0.0001). This difference was also observed in patients without a diagnosis of diabetes (P=0.027), in insulin-dependent diabetic (P=0.023) and non-insulin-dependent diabetic patients (P=0.034). In the overall series, HbA1c >70 mmol/mol (NGSP units, 8.6%) was associated with the highest risk of SWI (20.6% vs. 4.6%; adjusted OR, 5.01; 95% CI: 2.47-10.15). When dichotomized according to the cut-off 53 mmol/mol (NGSP units, 7.0%) as suggested both for diagnosis and optimal glycemic control of diabetes, HbA1c was associated with increased risk of SWI in the overall series (10.6% vs. 3.9%; adjusted OR, 2.09; 95% CI: 1.24-3.52), in diabetic patients (11.7% vs. 5.1%; adjusted OR, 2.69; 95% CI: 1.38-5.25), in patients undergoing elective surgery (9.9% vs. 2.7%; adjusted OR, 2.09; 95% CI: 1.24-3.52) and in patients with bilateral mammary artery grafts (13.7% vs. 4.8%; adjusted OR, 2.35; 95% CI: 1.17-4.69).CONCLUSIONS: Screening for HbA1c before CABG may identify untreated diabetic patients, as well as diabetic patients with suboptimal glycemic control, at high risk of SWI.
AB - BACKGROUND: Glycated hemoglobin (HbA1c) is a suspected risk factor for sternal wound infection (SWI) after CABG.Methods and Results:Data on preoperative HbA1c and SWI were available in 2,130 patients undergoing isolated CABG from the prospective E-CABG registry. SWI occurred in 114 (5.4%). Baseline HbA1c was significantly higher in patients with SWI (mean, 54±17 vs. 45±13 mmol/mol, P<0.0001). This difference was also observed in patients without a diagnosis of diabetes (P=0.027), in insulin-dependent diabetic (P=0.023) and non-insulin-dependent diabetic patients (P=0.034). In the overall series, HbA1c >70 mmol/mol (NGSP units, 8.6%) was associated with the highest risk of SWI (20.6% vs. 4.6%; adjusted OR, 5.01; 95% CI: 2.47-10.15). When dichotomized according to the cut-off 53 mmol/mol (NGSP units, 7.0%) as suggested both for diagnosis and optimal glycemic control of diabetes, HbA1c was associated with increased risk of SWI in the overall series (10.6% vs. 3.9%; adjusted OR, 2.09; 95% CI: 1.24-3.52), in diabetic patients (11.7% vs. 5.1%; adjusted OR, 2.69; 95% CI: 1.38-5.25), in patients undergoing elective surgery (9.9% vs. 2.7%; adjusted OR, 2.09; 95% CI: 1.24-3.52) and in patients with bilateral mammary artery grafts (13.7% vs. 4.8%; adjusted OR, 2.35; 95% CI: 1.17-4.69).CONCLUSIONS: Screening for HbA1c before CABG may identify untreated diabetic patients, as well as diabetic patients with suboptimal glycemic control, at high risk of SWI.
KW - Aged
KW - Coronary Artery Bypass/adverse effects
KW - Diabetes Mellitus/blood
KW - Female
KW - Glycated Hemoglobin A/metabolism
KW - Humans
KW - Male
KW - Middle Aged
KW - Risk Factors
KW - Sternum
KW - Surgical Wound Infection/blood
U2 - 10.1253/circj.CJ-16-0778
DO - 10.1253/circj.CJ-16-0778
M3 - SCORING: Journal article
C2 - 27928145
VL - 81
SP - 36
EP - 43
JO - CIRC J
JF - CIRC J
SN - 1346-9843
IS - 1
ER -