Cardiothoracic & vascular anesthesia
Intensive Care Unit Hyperglycemia After Cardiac Surgery: Risk Factors and Clinical Outcomes
Authors' conclusion
In the intensive care unit, hyperglycemia occurs frequently in patients immediately after cardiac surgery. Diabetes, high EuroSCORE II, and preoperative leukocytosis are independent risk factors for postoperative hyperglycemia. Hyperglycemia is associated with worse clinical outcomes, including a higher rate of acute kidney injury and ICU-acquired weakness, greater duration of mechanical ventilation, and a higher rate of multiorgan failure.
Study context
- Population
- Consecutive postoperative cardiac surgery patients admitted to the cardiac surgery intensive care unit (ICU)consecutive
- Participants
- 210 patients
- Exposure
- Postoperative glucose ≥180 vs <180 mg/dL
- Outcome
- Incidence of postoperative hyperglycemia (glucose ≥180 mg/dL)
Methodological detailssingle-centre, Blood glucose measured immediately after surgery and every 3 h for 7 days or until discharge; IV insulin per institutional protocol
- Single-centre
- Blood glucose measured immediately after surgery and every 3 h for 7 days or until discharge; IV insulin per institutional protocol
Main finding
As reported in the abstract
Incidence of postoperative hyperglycemia
30%
Observational data: associations, not effects.
Further findings
Independent risk factors for hyperglycemia
| OR (95% CI) | P value | ||
|---|---|---|---|
| Diabetes mellitus | 6.73 (3.2–14.3) | P < 0.001 | |
| White blood cell count | 1.28 (1.1–1.4) | P < 0.001 | |
| EuroSCORE II | 1.20 (1.1–1.4) | P = 0.004 | |
| 0.050.21520Odds ratio (log scale) |
AKI
P = 0.013
ICU-acquired weakness
P = 0.027
Multiorgan failure
P = 0.02
Duration of mechanical ventilation
P = 0.019
Duration of sedation
P = 0.034
Original publication
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