Glucose variability affects CABG outcomes
Glucose variability predicts poor outcomes after coronary artery bypass grafting (CABG), a recent study has found.
Researchers conducted a prospective observational study on 137 nondiabetic patients (mean age, 64.45±9.22 years; 67.9 percent male) who underwent CABG. Blood glucose was measured at 72 hours after the procedure and was used in the computation of glucose variability. Study outcomes included the duration of stay in the ICU, length of hospital stay, arrhythmia and mechanical ventilation time.
Majority of the participants had glucose levels ≥7.00 mmol/L and were identified as having hyperglycaemia (n=126; mean age, 64.88±8.98; 66.7 percent male). The remaining 11 patients were euglycaemic (mean age, 59.63±10.94 years; 81.8 percent male). Most participants also had abnormal glucose variability, with mean of daily difference (MODD) ≥1.40 mmol/L.
Compared with patients who had normal MODD, those with abnormal glucose variability were in the ICU for a longer time (68.19±37.72 vs 62.37±40.98 minutes), though duration of hospital stay was shorter (19.41±6.22 vs 22.13±12.3 days). Mechanical ventilation time was likewise shorter (22.41±18.45 vs 23.15±19.88 minutes), but the occurrence of arrhythmia was greater (23 percent vs 4.2 percent).
Multiple regression analysis identified postoperative blood glucose (t, 4.88; p<0.001) and ejection fraction (t, –6.02; p<0.001) as significant predictors of the length of ICU stay. MODD, on the other hand, was significantly associated with arrhythmia incidence (B, 1.513, 95 percent CI, 1.14–2.01; p=0.004).