Effect of glycemic control on mortality and infections in patients undergoing coronary artery bypass grafting: a Genesee County experience

Background: We report post-coronary artery bypass outcomes and factors affecting the outcomes from the Genesee County, MI, where the population is distinctly characterized by a higher prevalence of renal failure (RF), diabetes, obesity and smoking than the national average. Methods: We performed a r...

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Bibliographic Details
Published in:Journal of community hospital internal medicine perspectives 2019-03, Vol.9 (2), p.74-79
Main Authors: Khan, Mahin R., Khan, Hafiz, Wahab, Ahsan, Chaudhary, Siddique, Munir, Ahmad, Youssef, John, Mocanu, Marian, Ríos-Bedoya, Carlos F., Changezi, Hameem, Kesari, Kavitha
Format: Article
Language:English
Subjects:
Congestive heart failure
Coronary artery
coronary artery bypass graft
Coronary vessels
Diabetes mellitus
Health care
Heart surgery
Hemoglobin
Hemoglobin a1c
Infections
Mortality
Regression analysis
Renal failure
Sepsis
Smoking
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Summary:Background: We report post-coronary artery bypass outcomes and factors affecting the outcomes from the Genesee County, MI, where the population is distinctly characterized by a higher prevalence of renal failure (RF), diabetes, obesity and smoking than the national average. Methods: We performed a retrospective cohort study on 1133 patients undergoing isolated CABG at our hospital from June 2012 to July 2017. Primary outcome was the association between preoperative hemoglobin A1c (HbA1c) and all-cause postoperative mortality after CABG, secondary outcomes included the association between HbA1c and a composite of postoperative infections including sternal-wound infections, leg harvest-site infections, pneumonia or sepsis. Logistic Regression analyses were also performed. Results: There was no difference in the mortality rate (OR 1.0, 95% CI 0.4-2.3) and composite of all infections (OR 1.0, 95% CI 0.7-1.6) between the controlled (HbA1c ≤7%) and uncontrolled (HbA1c >7%) groups. However, RF (OR 5.9, 95% CI 1.5-22.9), smoking (OR 3.7, 95% CI 1.3-11.2) and ejection fraction
ISSN:2000-9666
2000-9666
DOI:10.1080/20009666.2019.1581044