Effects of intensive glycemic control on outcomes of cardiac surgery

Abstract

ObjectivesTo investigate the effects of postoperative intensive glycemic control on patient outcomes. BackgroundIneffective perioperative glycemic control has been associated with high mortality and morbidity rates among cardiac surgery patients. Methods212 cardiac surgery patients were allocated by a quasi-experimental design to: a) a control group (n = 107) with targeted blood glucose levels 161–200 mg/dl or b) a therapy group (n = 105) with blood glucose target 120–160 mg/dl. We compared the two groups on their mortality, length of stay, duration of intubation, incidence of severe hypoglycemia and frequency of postoperative infections. ResultsThe mean postoperative blood glucose levels were significantly lower for the therapy group compared with the control group (153.9 mg/dl vs. 173.9 md/dl, p < 0.001). The intensive glycemic control was strongly associated with decreased in-hospital mortality (7 deaths/105 patients for the control group vs. 1 death/105 patients for the therapy group; p = 0.033). We did not identify any statistically significant associations regarding the other patient outcomes. ConclusionsThis randomized quasi-experimental trial found lower in-hospital mortality with more intense blood glucose control. Effective postoperative glycemic control did not affect the other studied patient outcomes.