Evidence map›Paper›PMID 29067250›Full record

ArticleJournal of clinical & translational endocrinology2017

Basal insulin therapy is associated with beneficial effects on postoperative infective complications, independently from circulating glucose levels in patients admitted for cardiac surgery.

P M Piatti, M Cioni, A Magistro, V Villa, V G Crippa, E Galluccio, B Fontana, S Spadoni, E Bosi, L D Monti and 1 more

Open access · goldAbstract read
In one paragraph

Article in Journal of clinical & translational endocrinology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

P M PiattiCardio-Metabolism and Clinical Trials Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy.
M CioniCardio-Surgery Division, IRCCS San Raffaele Institute, Milan, Italy.
A MagistroCardio-Metabolism and Clinical Trials Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy.
V VillaCardio-Metabolism and Clinical Trials Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy.
V G CrippaCardio-Metabolism and Clinical Trials Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy.
E GalluccioCardio-Diabetes and Core Lab Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy.
B FontanaCardio-Diabetes and Core Lab Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy.
S SpadoniCardio-Diabetes and Core Lab Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy.
E BosiCardio-Metabolism and Clinical Trials Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy.
L D MontiCardio-Diabetes and Core Lab Unit, Diabetes Research Institute, Department of Internal Medicine, IRCCS San Raffaele Institute, Milan, Italy.
O AlfieriCardio-Surgery Division, IRCCS San Raffaele Institute, Milan, Italy.
Vita-Salute San Raffaele University · ITIstituto di Ricovero e Cura a Carattere Scientifico San RaffaeleIstituti di Ricovero e Cura a Carattere Scientifico · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough hyperglycemia is a strong predictor of postoperative infective complications (PIC), little is known about the effect of basal insulin therapy (BIT)

aimTo evaluate if there is an association between BIT, independent of glucose levels, and a possible improvement of PIC during the perioperative cardiosurgery period (PCP).

methodsIn 812 patients admitted for cardiac intervention and treated with a continuous intravenous insulin infusion (CIII) for hyperglycemic levels (>130 mg/dl), a retrospective analysis was performed during the PCP (January 2009-December 2011). Upon transfer to the cardiac surgery division, if fasting glucose was ≥130 mg/dl, a basal + premeal insulin therapy was initiated (121 patients, group 1); for <130 mg/dl, a premeal insulin alone was initiated (691 patients, group 2).

findingsCompared with group 2, group 1 showed reductions in PIC (2.48% vs 7.96%, p < 0.049; odds ratio: 0.294; 95% CI: 0.110-0.780), C-Reactive Protein (p < 0.05) and white blood cell (p < 0.05) levels despite glucose levels and CIII that were higher during the first two days after surgery (179.8 ± 25.3 vs 169.5 ± 10.6 mg/dl, p < 0.01; 0.046 ± 0.008 vs 0.037 ± 0.015 U/kg/h, p < 0.05, respectively). Normal glucose levels were achieved in both groups from day 3 before the discharge. The mean length of hospital duration was 18% lower in group 1 than in group 2 (7.21 ± 05.08 vs 8.76 ± 9.08 days, p < 0.007), providing a significant impact on public health costs.

conclusionsBasal + preprandial insulin therapy was associated with a lower frequency of PIC than preprandial insulin therapy alone, suggesting a beneficial effect of basal insulin therapy on post-surgery outcome.

Indexed as

BIT, basal insulin therapyCardiac surgeryCIII, continuous intravenous insulin infusionCRP, C-Reactive ProteinDM, diabetes mellitusHyperglycemiaHypoglycemiaICU, intensive care unitsInsulin therapyPCP, perioperative cardiosurgery periodPIC, postoperative infective complicationsPost-surgery infectionsWBC, white blood cell

Identifiers

PMID29067250
PMCPMC5651296
OpenAlexW2586573577

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.