Insulin use and clinical outcomes in patients undergoing coronary artery bypass graft surgery
Rev. bras. cir. cardiovasc
; 35(5): 666-674, Sept.-Oct. 2020. tab, graf
Artigo
em Inglês
| LILACS, Sec. Est. Saúde SP
| ID: biblio-1137347
Biblioteca responsável:
BR1.1
ABSTRACT
Abstract Objective:
To describe insulin use and postoperative glucose control in patients undergoing coronary artery bypass graft (CABG) surgery.Methods:
We examined 2,390 patients with and without diabetes enrolled in the Contemporary Analysis of Perioperative Cardiovascular Surgical Care (CAPS-Care) Study who underwent CABG surgery (01/2004 - 06/2005) to describe postoperative insulin use, variation in insulin use across different hospitals, and associated in-hospital complications and clinical outcomes. Logistic regression was used to assess the adjusted relationship between insulin use and clinical outcomes.Results:
Overall, insulin was used in 82% (n=1,959) of patients, including 95% (n=1,203) with diabetes (n=1,258) and 67% (n=756) without diabetes (n=1,132). Continuous insulin was used in 35.5% of patients in the operating room and in 56% in the intensive care unit. Continuous insulin use varied significantly among centers from 8-100% in patients with diabetes. When compared with all patients not receiving insulin, insulin use in patients without diabetes was associated with a higher rate of death or major complication (adjusted odds ratio [OR]=1.54; 95% confidence interval [CI] 1.15-2.04; P=0.003). In patients with diabetes, insulin use was not associated with a higher risk of adverse outcomes (adjusted OR=1.01; 95% CI 0.52-1.98; P=0.98).Conclusion:
The postoperative use of insulin is high among CABG patients in the United States of America. Insulin use in patients without diabetes was associated with worse clinical outcomes compared to patients (both with and without diabetes) who did not receive insulin. Further investigation is needed to determine the optimal use of postoperative insulin after CABG.
Texto completo:
Disponível
Coleções:
Bases de dados nacionais
/
Brasil
Contexto em Saúde:
6_ODS3_enfermedades_notrasmisibles
Base de dados:
LILACS
/
Sec. Est. Saúde SP
Assunto principal:
Ponte de Artéria Coronária
/
Insulina
Tipo de estudo:
Estudo de etiologia
/
Estudo prognóstico
/
Fatores de risco
Limite:
Humanos
/
Masculino
País/Região como assunto:
América do Norte
Idioma:
Inglês
Revista:
Rev. bras. cir. cardiovasc
Ano de publicação:
2020
Tipo de documento:
Artigo
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