Increased Glucose Variability Is Associated With Major Adverse Events After Coronary Artery Bypass

Publication date: Available online 7 August 2019Source: The Annals of Thoracic SurgeryAuthor(s): Kathleen C. Clement, Alejandro Suarez-Pierre, Krisztian Sebestyen, Diane Alejo, Joseph DiNatale, Glenn J.R. Whitman, Thomas L. Matthew, Jennifer S. LawtonAbstractBackgroundElevated preoperative hemoglobin A1c (HbA1c) is a predictor of poor outcomes following coronary artery bypass grafting (CABG), but the role of postoperative glucose variability (GV) is unknown. We hypothesized that short-term postoperative GV is associated with major adverse events (MAEs) following isolated CABG.MethodsRetrospective study evaluated 2,215 patients who underwent isolated CABG from January 2012 to March 2018 at two medical centers. Postoperative glucose variability in the first 12 hours and 24 hours was measured by standard deviation, coefficient of variation, and mean amplitude of glycemic excursions. The primary outcome (MAE) was the composite of postoperative cardiac arrest, pneumonia, renal failure, stroke, sepsis, reoperation, and 30-day mortality. Multivariate logistic regression assessed the independent association of GV with MAE.ResultsA total of 2,215 patients met the study criteria, and 260 patients (11.7%) developed a MAE. High 12-hour and 24-hour postoperative GV were associated with elevated HbA1c, insulin-dependent diabetes, renal failure, and non-elective surgery. Using multivariate logistic regression, MAEs were associated with increased mean postoperative glucose in the first 12 ho...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research

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This study aims, first, to validate a retrospectively-gated implementation of the DENSE method for assessing brain tissue pulsations as a physiological marker, and second, to use the acquired measurements to explore intracranial volume dynamics. We acquired repeated measurements of cerebral volumetric strain in 8 healthy subjects, and internally validated these measurements by comparing them to spinal CSF stroke volumes obtained in the same scan session.Peak volumetric strain was found to be highly repeatable between scan sessions. First/second measured peak volumetric strains were: (6.4 ± 1.7)x10−4/(6.7...
Source: NeuroImage - Category: Neuroscience Source Type: research
Publication date: January 2020Source: The Annals of Thoracic Surgery, Volume 109, Issue 1Author(s): Elisabetta Lapenna, Michele De Bonis, Ilaria Giambuzzi, Benedetto Del Forno, Stefania Ruggeri, Manuela Cireddu, Simone Gulletta, Alessandro Castiglioni, Ottavio Alfieri, Paolo Della Bella, Stefano BenussiBackgroundThe study sought to assess the long-term outcomes of the stand-alone Cox-Maze IV procedure in symptomatic patients with refractory, persistent, or long-standing persistent atrial fibrillation (AF).MethodsFifty-nine consecutive patients (mean age 52 ± 10.5 years, previous catheter ablation 80%, left ventricul...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Abstract BACKGROUND: Elevated preoperative hemoglobin A1c (HbA1c) is a predictor of poor outcomes following coronary artery bypass grafting (CABG), but the role of postoperative glucose variability (GV) is unknown. We hypothesized that short-term postoperative GV is associated with major adverse events (MAEs) following isolated CABG. METHODS: Retrospective study evaluated 2,215 patients who underwent isolated CABG from January 2012 to March 2018 at two medical centers. Postoperative glucose variability in the first 12 hours and 24 hours was measured by standard deviation, coefficient of variation, and mean am...
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
Several previous reports have elucidated the mortality and incidence of complications after pediatric scoliosis surgery using nationwide databases. However, all of these studies were conducted in North America. Hence, this study aimed to identify the incidence and risk factors for in-hospital mortality and morbidity in pediatric scoliosis surgery, utilizing the Diagnosis Procedure Combination database, a national inpatient database in Japan. We retrospectively extracted data for patients aged less than 19 years who were admitted between 01 June 2010 and 31 March 2013 and underwent scoliosis surgery with fusion. The primar...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Conclusions Previous history of abdominal transplant is associated with an increased 30-day incidence of stroke after cardiac surgery. Abdominal transplant does not affect 30-day mortality after cardiac surgery, whereas long-term survival is significantly reduced. Regular patient follow-up and prevention and early treatment of postoperative complications are key to patient survival.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Conclusions: Heat waves can confer additional risks of ED visits beyond those of daily air temperature, even in a region with high air-conditioning prevalence. https://doi.org/10.1289/EHP44 Received: 29 February 2016 Revised: 13 October 2016 Accepted: 24 October 2016 Published: 31 May 2017 Address correspondence to H.H. Chang, Department of Biostatistics and Bioinformatics, Emory University, 1518 Clifton Rd. NE, Atlanta, Georgia 30322. Telephone: (404) 712-4627; E-mail: howard.chang@emory.edu Supplemental Material is available online (https://doi.org/10.1289/EHP44). The authors declare they have no actual ...
Source: EHP Research - Category: Environmental Health Authors: Tags: Research Source Type: research
Conclusions Redo CABG can be performed safely with low early and late morbidity and mortality. Important predictors of long-term mortality such as age, diabetes, renal disease, and peripheral vascular disease were identified and should guide the treatment strategy chosen for this challenging group of patients.
Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
IntroductionCarotid stenting (CAS) has been widely used since the seminal CREST trial, demonstrating equivalent results to carotid endarterectomy (CEA). With normal surgical risk patients having symptomatic or asymptomatic carotid artery disease, CAS and CEA, in qualified hands, have comparable outcomes, but patient-specific risk factors to estimate functional outcome were poorly studied. In practice, the choice between CEA and CAS is based on lesion anatomy and preference of patient and surgeon rather than considering defined risk factors associated with unfavorable outcome. We aimed to determine medical risk factors for ...
Source: Journal of NeuroInterventional Surgery - Category: Neurosurgery Authors: Tags: Oral abstracts Source Type: research
ConclusionsThere were no differences in hospital outcome among races/ethnicities in endovascular thrombectomy outcomes for acute stroke patients in the Premier data. Racial/ethnic disparities play role for patients’ selection not for patients’ outcome in endovascular thrombectomy.DisclosuresS. Park: None. M. Pilot: None. M. Alexander: 1; C; Consultant for Stryker Neurovascular, Medtronic, and Penumbra, Inc. A. Rosengart: None.
Source: Journal of NeuroInterventional Surgery - Category: Neurosurgery Authors: Tags: Oral poster abstracts Source Type: research
The objective of this study was to obtain further information about the health status and health needs of IDP women and children, aged 15 and under, living in the informal settlements in central Iraq. The study was conducted between February and June 2015. Our focus was on settlements in Baghdad, Karbala and Kirkuk, which between them hosted an estimated 688,944 IDPs, about a third of Iraq’s IDPs.14 This estimate is undoubtedly low as some IDPs were not counted or registered. It is the hope that information from this study will help improve access to services for this vulnerable population. These governorates were ...
Source: PLOS Currents Disasters - Category: Global & Universal Authors: Source Type: research
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