Author + information
- Renato D. Lopes,
- Alvaro Albrecht,
- Judson Williams,
- Shuang Li,
- T. Ferguson,
- Renato Kalil,
- Adrian Hernandez and
- Eric Peterson
Guidelines recommend that patients undergoing coronary artery bypass graft (CABG) have their glucose closely monitored and controlled in the perioperative period. Little is known about glucose control and insulin use in this population.
We studied 2,099 patients undergoing CABG surgery at 55 hospitals participating in the Contemporary Analysis of Perioperative Cardiovascular Surgical Care (CAPS-Care) registry. We described perioperative glucose control (defined as a glucose level between 70 and 180 mg/dL), its variation across different hospitals, and the rates of insulin use.
Overall, while insulin was used in 1,868/2,099 (89%) patients in the operating room (OR) or in the first 24 hours after surgery in the intensive care unit (ICU), the use of continuous insulin drip in this setting varied substantially across the hospitals (see figure). Overall, 750 patients (35.7%) in the OR maintained good glucose control (range 2.6% to 70.6% among hospitals). Overall, 623 patients (29.7%) in the ICU had good glucose control, ranging from 3.5% to 67.2% among hospitals.
Our study highlights the variability in strategies used for controlling glucose levels in patients undergoing CABG surgery. Despite the high rate of insulin use, only a minority of hospitals achieve good perioperative glucose control.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Disparities and Cardiovascular Epidemiology
Abstract Category: 28. Quality of Care and Outcomes Assessment
Presentation Number: 1244-102
- 2013 American College of Cardiology Foundation