Prognostic Value of the Leuko-Glycaemic Index in the Postoperative Period of Coronary Artery Bypass Grafting.


Journal

Brazilian journal of cardiovascular surgery
ISSN: 1678-9741
Titre abrégé: Braz J Cardiovasc Surg
Pays: Brazil
ID NLM: 101677045

Informations de publication

Date de publication:
06 08 2021
Historique:
pubmed: 9 7 2021
medline: 12 10 2021
entrez: 8 7 2021
Statut: epublish

Résumé

High leuko-glycaemic index (LGI) (> 2000) has been associated with poor prognosis in many critical care settings. However, there is no evidence of LGI's prognostic value in the postoperative period of coronary artery bypass grafting (CABG). This study aims to analyze the prognostic value of LGI in the postoperative period of CABG. Single-center retrospective analysis of prospectively collected data was performed. Consecutive adult patients undergoing CABG between 2007 and 2019 were included. Blood glucose levels and white blood cells count were evaluated in the immediate postoperative period. LGI was calculated by multiplying both values and dividing them by 1,000 and analyzed in quartiles. Receiver operating characteristic curve was used to determine the best cutoff value. The primary combined endpoint was in-hospital mortality, low cardiac output (LCO), or acute kidney injury (AKI). Secondary endpoints included in-hospital death, AKI, atrial fibrillation, and LCO. The study evaluated 3,813 patients undergoing CABG (88.5% male, 89.8% off-pump surgery, aged 64.6 years [standard deviation 9.6]). The median of LGI was 2,035. Presence of primary endpoint significantly increased per LGI quartile (9.2%, 9.7%, 11.8%, and 15%; P<0.001). High LGI was associated with increased occurrence of in-hospital mortality, LCO, AKI, and atrial fibrillation. The best prognostic cutoff value for primary endpoint was 2,000. In a multivariate logistic regression model, high LGI was independently associated with in-hospital death, LCO, or AKI. High LGI was an independent predictor of inhospital mortality, LCO, or AKI in postoperative period of CABG. It was also associated with higher in-hospital death.

Identifiants

pubmed: 34236791
doi: 10.21470/1678-9741-2020-0349
pmc: PMC8522313
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

484-491

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Auteurs

Leonardo Adrián Seoane (LA)

Department of Critical Care Cardiology, Instituto Cardiovascular de Buenos Aires (ICBA), Buenos Aires, Argentina.

Lucrecia Burgos (L)

Department of Heart Failure, Instituto Cardiovascular de Buenos Aires (ICBA), Buenos Aires, Argentina.

Juan Carlos Espinoza (JC)

Department of Cardiovascular Surgery, Instituto Cardiovascular de Buenos Aires (ICBA), Buenos Aires, Argentina.

Juan Francisco Furmento (JF)

Department of Critical Care Cardiology, Instituto Cardiovascular de Buenos Aires (ICBA), Buenos Aires, Argentina.

Mariano Noel Benzadón (MN)

Department of Critical Care Cardiology, Instituto Cardiovascular de Buenos Aires (ICBA), Buenos Aires, Argentina.

Juan Mariano Vrancic (JM)

Department of Cardiovascular Surgery, Instituto Cardiovascular de Buenos Aires (ICBA), Buenos Aires, Argentina.

Fernando Piccinini (F)

Department of Cardiovascular Surgery, Instituto Cardiovascular de Buenos Aires (ICBA), Buenos Aires, Argentina.

Daniel Navia (D)

Department of Cardiovascular Surgery, Instituto Cardiovascular de Buenos Aires (ICBA), Buenos Aires, Argentina.

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Classifications MeSH