ArticleDiabetes care2016
Diabetes and the Association of Postoperative Hyperglycemia With Clinical and Economic Outcomes in Cardiac Surgery.
Article in Diabetes care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
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Who cites it
31 citing papers in PubMed, 70 citations in OpenAlex.
- Association of Postoperative Stress Hyperglycemia Ratio with Suspected Infection, Culture Positivity, Sepsis, and Septic Shock in 1408 Patients After Cranial Neurosurgery.Journal of clinical medicine · 2026Article
- Dysglycaemia and the interaction of chronic and acute glycaemia with mortality post cardiac surgery.Scientific reports · 2025Article
- Glycemic variability and postoperative mortality following cardiac surgery: evidence from a real-world ICU cohort.BMC cardiovascular disorders · 2025Observational
- Reality of post-gastrectomy stress hyperglycemia revealed by continuous glucose monitoring: a prospective study.Surgery today · 2025Article
- The impact of perioperative hyperglycemia on postoperative cognitive function: A comprehensive review.IBRO neuroscience reports · 2025Review
- A distributional reinforcement learning model for optimal glucose control after cardiac surgery.NPJ digital medicine · 2025Article
- [Diabetes mellitus and obesity: risk optimization before surgical interventions].Orthopadie (Heidelberg, Germany) · 2025Review
- Perioperative Considerations of Novel Antidiabetic Agents in Heart Failure Patients Undergoing Cardiac Surgery.Life (Basel, Switzerland) · 2025Review
- Diabetes Control and the Occurrence of Postoperative Hyperglycemia Among Adults With Type 1 and Type 2 Diabetes in a Tertiary Care Center.International journal of endocrinology · 2025Article
- Correlation of Blood Glucose Control With Cystoid Macular Edema and Central Macular Thickness After Cataract Surgery in Diabetics.Clinical ophthalmology (Auckland, N.Z.) · 2025Article
- The relationship between blood glucose and clinical outcomes after extracorporeal circulation: a retrospective cohort study.Frontiers in cardiovascular medicine · 2025Article
- Risk factors and clinical outcome of postoperative hyperglycemia after cardiac surgery with cardiopulmonary bypass.Frontiers in cardiovascular medicine · 2025Article
- The prognosis of patients with postoperative hyperglycemia after Stanford type A aortic dissection surgery and construction of prediction model for postoperative hyperglycemia.Frontiers in endocrinology · 2023Article
- [Position statement: surgery and diabetes mellitus (Update 2023)].Wiener klinische Wochenschrift · 2023Article
- Predictors of Success following Microvascular Replantation Surgery of the Upper Extremity in Adult Patients.Plastic and reconstructive surgery. Global open · 2022Article
- Developing an Institute for Health Care Delivery Science: successes, challenges, and solutions in the first five years.Health care management science · 2021Article
- Article
- Association of postoperative glycemic control with outcomes after carotid procedures.Vascular · 2020Article
- [Position statement: surgery and diabetes mellitus (Update 2019)].Wiener klinische Wochenschrift · 2019Review
- Adverse Outcomes after Major Surgeries in Patients with Diabetes: A Multicenter Matched Study.Journal of clinical medicine · 2019Article
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Authors and funding
20 authors at 10 institutions in 1 country.
Funding
Abstract
objectiveThe management of postoperative hyperglycemia is controversial and generally does not take into account pre-existing diabetes. We analyzed clinical and economic outcomes associated with postoperative hyperglycemia in cardiac surgery patients, stratifying by diabetes status. RESEARCH DESIGN AND
methodsMulticenter cohort study in 4,316 cardiac surgery patients operated on in 2010. Glucose was measured at 6-h intervals for 48 h postoperatively. Outcomes included cost, hospital length of stay (LOS), cardiac and respiratory complications, major infections, and death. Associations between maximum glucose levels and outcomes were assessed with multivariable regression and recycled prediction analyses.
resultsIn patients without diabetes, increasing glucose levels were associated with a gradual worsening of outcomes. In these patients, hyperglycemia (≥180 mg/dL) was associated with an additional cost of $3,192 (95% CI 1,972 to 4,456), an additional hospital LOS of 0.8 days (0.4 to 1.3), an increase in infections of 1.6% (0.5 to 2.8), and an increase in respiratory complications of 2.6% (0.0 to 5.3). However, among patients with insulin-treated diabetes, optimal outcomes were associated with glucose levels considered to be hyperglycemic (180 to 240 mg/dL). This level of hyperglycemia was associated with cost reductions of $6,225 (-12,886 to -222), hospital LOS reductions of 1.6 days (-3.7 to 0.4), infection reductions of 4.1% (-9.1 to 0.0), and reductions in respiratory complication of 12.5% (-22.4 to -3.0). In patients with non-insulin-treated diabetes, outcomes did not differ significantly when hyperglycemia was present.
conclusionsGlucose levels <180 mg/dL are associated with better outcomes in most patients, but worse outcomes in patients with diabetes with a history of prior insulin use. These findings support further investigation of a stratified approach to the management of patients with stress-induced postoperative hyperglycemia based on prior diabetes status.
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