| Autor: |
Magdalena Bogun, Matthew A. Beier, Sameer K. Singh, Denise McLaughlin, Yuming Ning, Paul Kurlansky, Syed T. Raza |
| Rok vydání: |
2021 |
| Předmět: |
|
| Zdroj: |
Journal of cardiac surgeryREFERENCES. 37(4) |
| ISSN: |
1540-8191 |
| Popis: |
Postoperative hyperglycemia occurs in up to 80% of cardiac surgery patients and is associated with poor outcomes. We sought to determine if case-based diabetes workshops for providers would improve postoperative glycemic control and outcomes in patients undergoing coronary artery bypass grafting (CABG).Healthcare providers taking care of patients in the cardiothoracic step-down unit underwent 30-min weekly case-based diabetes workshops over 6 months. Workshops focused on initiation of insulin treatment, titration of insulin dosing, and transitioning from insulin drips to subcutaneous insulin. Isolated-CABG patients were recorded during 29-month periods before (Jan 2013-June 2015) and after training (Jan 2016-June 2018). Glycemic control and outcomes were compared between groups balanced for preoperative risk factors using inverse probability treatment weights.A total of 938 and 1032 patients were included in pre- and posttraining groups, respectively. Compared to the pretraining period, the posttraining period had a lower median of mean patient day glucose levels (151 vs. 144 mg/dl, p .001) and percentage of patient days with a glucose level250 mg/dl (20% vs. 14%, p .001). The percentage of patient days with mean glucose values in the target range (80-180 mg/dl) increased from 71% to 77% (p .001). The incidence of hypoglycemic events did not significantly change after training (p = .15). The incidence of sepsis was significantly lower in the posttraining period (1.7% vs. 0.2%, p .001).Weekly diabetes workshops for healthcare providers were associated with improved glycemic control and reduced postoperative sepsis among isolated CABG patients. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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