Cardiothoracic & vascular anesthesia
Postcardiac Surgery Euglycemic Diabetic Ketoacidosis in Patients on Sodium-Glucose Cotransporter 2 Inhibitors
Authors' conclusion
Postoperative eDKA occurred in 15% of patients on an SGLT2i prior to cardiac surgery, and was associated with longer CVICU LOS.
Study context
- Population
- Adults undergoing cardiac surgery at an academic university hospital, February 2019 to May 2022
- Participants
- 1,654 adults
- Exposure
- SGLT2i use vs no SGLT2i use
- SGLT2in = 53
- Outcome
- SGLT2i prevalence and eDKA frequency
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
eDKA in SGLT2i users
SGLT2i
15.1%
8 of 53
- SGLT2i prescribed before surgery
- 53 (3.2%)
Observational data: associations, not effects.
Further findings
Hospital LOS · no difference
P = 0.46
CVICU LOS · no difference
P = 0.22
30-day mortality · no difference
P = 0.31
| Outcome | P value |
|---|---|
| Hospital LOS, SGLT2i patients with vs without eDKA (subgroup)Similar | P = 0.76 |
| CVICU LOS, SGLT2i patients with vs without eDKA (subgroup)Longer with eDKA | P = 0.042 |
- Mortality, SGLT2i patients with vs without eDKA (subgroup) — Mortality similarly rare, eDKA vs no eDKA · similarly rare
- 0.0% v 2.2% · P = 0.67
- Hospital LOS, SGLT2i patients with vs without eDKA (subgroup): eDKA 5.1 (IQR 4.0–5.8)
- Hospital LOS, SGLT2i patients with vs without eDKA (subgroup): No eDKA 4.4 (IQR 3.4–6.3)
- CVICU LOS, SGLT2i patients with vs without eDKA (subgroup): eDKA 2.2 (IQR 1.5–2.9)
- CVICU LOS, SGLT2i patients with vs without eDKA (subgroup): No eDKA 1.2 (IQR 0.9–2.0)
Safety
Sternal infections · no difference
P = 0.69
- Wound infections, SGLT2i patients with vs without eDKA (subgroup) — Wound infections similarly rare, eDKA vs no eDKA · similarly rare
- 0.0% v 0.0% · P > 0.99
Original publication
Postcardiac Surgery Euglycemic Diabetic Ketoacidosis in Patients on Sodium-Glucose Cotransporter 2 Inhibitors. J Cardiothorac Vasc Anesth. Published 7 February 2023. doi:10.
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