Strict glycemic control improves outcomes after coronary artery bypass grafting (CABG)
Abstract
Objectives: This study aims at investigating the effects of maintaining blood glucose levels between 120-150 mg/dl on diabetic patients undergoing myocardial revascularization.
Methodology: The glucose control management in two groups of diabetic patients undergoing myocardial revascularization was compared; group (1) using insulin infusion to achieve a serum glucose level between 120-150 mg/dl, and group (2) a historical group of 145 patients with glucose control achieved by interval insulin dosing. Rates of wound infection (superficial and deep), Length of stay (ICU and hospital) and mortality were investigated.
Results: There were four patients with superficial wound infection in the strict group (3.3%); whilst there were nine patients in the control group (6.2%) giving a significant p value. None of the study patients had deep seated wound infection compared with two patients in the control group (1.3%). ICU stay was 20±2 hours in the study group compared to 22±3 in the control group (p value > 0.05). In terms of hospital stay the study group had mean of 5.7±1.5 days compared to 6.8±2.5 days in the control group giving a P value < 0.05. Both groups had similar mortality rates. Group I had 5 hypoglycemic episodes occurring in three patients whilst only one patient in group II had a single hypoglycemic episode but the difference was not statistically significant.
Conclusion: Strict glycemic control decreases rates of wound infection and duration of hospitalization but had no effect on ICU stay or mortality.
Methodology: The glucose control management in two groups of diabetic patients undergoing myocardial revascularization was compared; group (1) using insulin infusion to achieve a serum glucose level between 120-150 mg/dl, and group (2) a historical group of 145 patients with glucose control achieved by interval insulin dosing. Rates of wound infection (superficial and deep), Length of stay (ICU and hospital) and mortality were investigated.
Results: There were four patients with superficial wound infection in the strict group (3.3%); whilst there were nine patients in the control group (6.2%) giving a significant p value. None of the study patients had deep seated wound infection compared with two patients in the control group (1.3%). ICU stay was 20±2 hours in the study group compared to 22±3 in the control group (p value > 0.05). In terms of hospital stay the study group had mean of 5.7±1.5 days compared to 6.8±2.5 days in the control group giving a P value < 0.05. Both groups had similar mortality rates. Group I had 5 hypoglycemic episodes occurring in three patients whilst only one patient in group II had a single hypoglycemic episode but the difference was not statistically significant.
Conclusion: Strict glycemic control decreases rates of wound infection and duration of hospitalization but had no effect on ICU stay or mortality.
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