Prognostic Value of the Leuko-Glycaemic Index in the Postoperative Period of Coronary Artery Bypass Grafting.
Aged
Cardiac Output, Low
Cardiac Surgical Procedures
Critical Care
Glycemic Index
Leukocytes
Postoperative Period
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
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
484-491Références
Rev Bras Cir Cardiovasc. 2012 Jan-Mar;27(1):7-17
pubmed: 22729296
Ann Thorac Surg. 2003 May;75(5):1392-9
pubmed: 12735552
Braz J Cardiovasc Surg. 2018 May-Jun;33(3):233-241
pubmed: 30043915
Ann Thorac Surg. 1994 Jan;57(1):6-7
pubmed: 8279920
Rev Bras Cir Cardiovasc. 2012 Jan-Mar;27(1):61-5
pubmed: 22729302
Braz J Cardiovasc Surg. 2020 Oct 01;35(5):666-674
pubmed: 33118731
Crit Care Med. 1985 Oct;13(10):818-29
pubmed: 3928249
Crit Care Med. 1995 Nov;23(11):1843-50
pubmed: 7587260
Crit Care. 2006;10(6):R167
pubmed: 17134504
Ann Thorac Surg. 2009 Feb;87(2):663-9
pubmed: 19161815
J Cardiothorac Vasc Anesth. 2012 Feb;26(1):52-7
pubmed: 21924630
Am J Cardiol. 2003 Jul 1;92(1):74-6
pubmed: 12842253
Anesth Analg. 2010 Nov;111(5):1244-51
pubmed: 20829561
Eur J Cardiothorac Surg. 2012 Apr;41(4):734-44; discussion 744-5
pubmed: 22378855
Ann Thorac Surg. 2003 Feb;75(2):S715-20
pubmed: 12607717
Thorac Cardiovasc Surg. 2013 Dec;61(8):708-17
pubmed: 24338631
J Thorac Cardiovasc Surg. 2005 Oct;130(4):1144
pubmed: 16214532
Clin Investig Arterioscler. 2014 Jul-Aug;26(4):168-75
pubmed: 24565746
Rev Bras Cir Cardiovasc. 2014 Jul-Sep;29(3):360-6
pubmed: 25372910
Braz J Cardiovasc Surg. 2019 Mar-Apr;34(2):125-135
pubmed: 30916121
Br J Anaesth. 2011 Sep;107(3):344-50
pubmed: 21680601
Eur J Cardiothorac Surg. 1999 Jul;16(1):9-13
pubmed: 10456395
JAMA. 2001 Oct 10;286(14):1754-8
pubmed: 11594901
Eur J Cardiothorac Surg. 2002 Feb;21(2):232-44
pubmed: 11825729