학술논문
Glycated Hemoglobin and Risk of Sternal Wound Infection After Isolated Coronary Surgery
Document Type
Journal Article
Author
Andrea Perrotti; Aniello Pappalardo; Antonino S. Rubino; Carmelo Dominici; Daniel Reichart; Daniele Maselli; Eeva-Maija Kinnunen; Fausto Biancari; Francesco Nicolini; Francesco Onorati; Francesco Santini; Giovanni Mariscalco; Giuseppe Faggian; Giuseppe Gatti; Giuseppe Santarpino; Luca Maschietto; Magnus Dalén; Marisa De Feo; Matteo Saccocci; Peter Svenarud; Riccardo Gherli; Saverio Nardella; Sidney Chocron; Theodor Fischlein; Tuomas Tauriainen; Vito G. Ruggieri
Source
Circulation Journal. 2016, 81(1):36
Subject
Language
English
ISSN
1346-9843
1347-4820
1347-4820
Abstract
Methods and Results:Data on preoperative HbA1c and SWI were available in 2,130 patients undergoing isolated CABG from the prospective E-CABG registry. SWI occurred in 114 (5.4%). Baseline HbA1c was significantly higher in patients with SWI (mean, 54±17 vs. 45±13 mmol/mol, P<0.0001). This difference was also observed in patients without a diagnosis of diabetes (P=0.027), in insulin-dependent diabetic (P=0.023) and non-insulin-dependent diabetic patients (P=0.034). In the overall series, HbA1c >70 mmol/mol (NGSP units, 8.6%) was associated with the highest risk of SWI (20.6% vs. 4.6%; adjusted OR, 5.01; 95% CI: 2.47–10.15). When dichotomized according to the cut-off 53 mmol/mol (NGSP units, 7.0%) as suggested both for diagnosis and optimal glycemic control of diabetes, HbA1c was associated with increased risk of SWI in the overall series (10.6% vs. 3.9%; adjusted OR, 2.09; 95% CI: 1.24–3.52), in diabetic patients (11.7% vs. 5.1%; adjusted OR, 2.69; 95% CI: 1.38–5.25), in patients undergoing elective surgery (9.9% vs. 2.7%; adjusted OR, 2.09; 95% CI: 1.24–3.52) and in patients with bilateral mammary artery grafts (13.7% vs. 4.8%; adjusted OR, 2.35; 95% CI: 1.17–4.69).