Utility of glycated hemoglobin screening in patients undergoing elective coronary artery surgery: Prospective, cohort study from the E-CABG registry
Standard
Utility of glycated hemoglobin screening in patients undergoing elective coronary artery surgery: Prospective, cohort study from the E-CABG registry. / Nicolini, Francesco; Santarpino, Giuseppe; Gatti, Giuseppe; Reichart, Daniel; Onorati, Francesco; Faggian, Giuseppe; Dalén, Magnus; Khodabandeh, Sorosh; Fischlein, Theodor; Maselli, Daniele; Nardella, Saverio; Rubino, Antonino S; De Feo, Marisa; Salsano, Antonio; Gherli, Riccardo; Mariscalco, Giovanni; Kinnunen, Eeva-Maija; Ruggieri, Vito G; Bounader, Karl; Saccocci, Matteo; Chocron, Sidney; Airaksinen, Juhani; Perrotti, Andrea; Biancari, Fausto.
in: INT J SURG, Jahrgang 53, 05.2018, S. 354-359.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Utility of glycated hemoglobin screening in patients undergoing elective coronary artery surgery: Prospective, cohort study from the E-CABG registry
AU - Nicolini, Francesco
AU - Santarpino, Giuseppe
AU - Gatti, Giuseppe
AU - Reichart, Daniel
AU - Onorati, Francesco
AU - Faggian, Giuseppe
AU - Dalén, Magnus
AU - Khodabandeh, Sorosh
AU - Fischlein, Theodor
AU - Maselli, Daniele
AU - Nardella, Saverio
AU - Rubino, Antonino S
AU - De Feo, Marisa
AU - Salsano, Antonio
AU - Gherli, Riccardo
AU - Mariscalco, Giovanni
AU - Kinnunen, Eeva-Maija
AU - Ruggieri, Vito G
AU - Bounader, Karl
AU - Saccocci, Matteo
AU - Chocron, Sidney
AU - Airaksinen, Juhani
AU - Perrotti, Andrea
AU - Biancari, Fausto
N1 - Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.
PY - 2018/5
Y1 - 2018/5
N2 - BACKGROUND: Patients with increased glycated hemoglobin (HbA1c) seem to be at increased risk of sternal wound infection (SWI) after coronary artery bypass grafting (CABG). However, it is unclear whether increased baseline HbA1c levels may affect other postoperative outcomes.MATERIAL AND METHODS: Data on preoperative levels of HbA1c were collected from 2606 patients undergoing elective isolated CABG from 2015 to 2016 and included in the prospective, multicenter E-CABG registry.RESULTS: The prevalence of HbA1c ≥ 53 mmol/mol (7.0%) among non-diabetics was 5.3%, among non-insulin dependent diabetics was 53.5% and among insulin dependent diabetics was 67.1% (p < 0.001). The prevalence of HbA1c > 75 mmol/mol (9.0%) among non-diabetics was 0.5%, among non-insulin dependent diabetics was 5.8% and among insulin dependent diabetics was 10.6% (p < 0.001). Baseline levels of HbA1c ≥ 53 mmol/mol (7.0%) was a significant predictor of any SWI (10.7% vs. 3.3%, adjusted p-value: <0.001), deep SWI/mediastinitis (3.8% vs. 1.3%, adjusted p-value: 0.001) and acute kidney injury (27.4% vs. 19.8%, adjusted p-value: 0.042). These findings were confirmed in multilevel mixed effect logistic regression adjusted for participating centers. Among patients with diabetes, HbA1c ≥ 53 mmol/mol (7.0%) was predictive of SWI (11.1% vs. 4.8%, p = 0.001).CONCLUSIONS: HbA1c is increased in a significant proportion of patients undergoing elective CABG and these patients are at higher risk of SWI. Less clear is the impact of increased HbA1c on other postoperative outcomes. These results do not support screening of HbA1c in patients without history of diabetes. Preoperative screening of HbA1c is valuable only to identify diabetics at risk of SWI.
AB - BACKGROUND: Patients with increased glycated hemoglobin (HbA1c) seem to be at increased risk of sternal wound infection (SWI) after coronary artery bypass grafting (CABG). However, it is unclear whether increased baseline HbA1c levels may affect other postoperative outcomes.MATERIAL AND METHODS: Data on preoperative levels of HbA1c were collected from 2606 patients undergoing elective isolated CABG from 2015 to 2016 and included in the prospective, multicenter E-CABG registry.RESULTS: The prevalence of HbA1c ≥ 53 mmol/mol (7.0%) among non-diabetics was 5.3%, among non-insulin dependent diabetics was 53.5% and among insulin dependent diabetics was 67.1% (p < 0.001). The prevalence of HbA1c > 75 mmol/mol (9.0%) among non-diabetics was 0.5%, among non-insulin dependent diabetics was 5.8% and among insulin dependent diabetics was 10.6% (p < 0.001). Baseline levels of HbA1c ≥ 53 mmol/mol (7.0%) was a significant predictor of any SWI (10.7% vs. 3.3%, adjusted p-value: <0.001), deep SWI/mediastinitis (3.8% vs. 1.3%, adjusted p-value: 0.001) and acute kidney injury (27.4% vs. 19.8%, adjusted p-value: 0.042). These findings were confirmed in multilevel mixed effect logistic regression adjusted for participating centers. Among patients with diabetes, HbA1c ≥ 53 mmol/mol (7.0%) was predictive of SWI (11.1% vs. 4.8%, p = 0.001).CONCLUSIONS: HbA1c is increased in a significant proportion of patients undergoing elective CABG and these patients are at higher risk of SWI. Less clear is the impact of increased HbA1c on other postoperative outcomes. These results do not support screening of HbA1c in patients without history of diabetes. Preoperative screening of HbA1c is valuable only to identify diabetics at risk of SWI.
KW - Acute Kidney Injury/epidemiology
KW - Aged
KW - Biomarkers/blood
KW - Cohort Studies
KW - Coronary Artery Bypass
KW - Diabetes Mellitus/blood
KW - Female
KW - Glycated Hemoglobin A/analysis
KW - Humans
KW - Male
KW - Postoperative Complications/epidemiology
KW - Registries
KW - Surgical Wound Infection/epidemiology
U2 - 10.1016/j.ijsu.2018.04.021
DO - 10.1016/j.ijsu.2018.04.021
M3 - SCORING: Journal article
C2 - 29665452
VL - 53
SP - 354
EP - 359
JO - INT J SURG
JF - INT J SURG
SN - 1743-9191
ER -
