- Meeting abstract
- Open access
- Published:
Is pre-operative haemoglobin A1c level a successful predictor of adverse outcome after cardiac surgery?
Journal of Cardiothoracic Surgery volume 10, Article number: A328 (2015)
An Erratum to this article was published on 31 March 2017
Background/Introduction
Uncontrolled diabetes mellitus increases morbidity and mortality after cardiac surgery. Haemoglobin A1c (Hb A1c) is used to measure long-term glucose control. There have been reports of a higher incidence of wound infections with uncontrolled Hb A1c levels in patients undergoing cardiac surgery.
Aims/Objectives
To establish clinical significance of elevated HbA1c level among patients who underwent cardiac surgery, and whether this may influence their postoperative mortality and morbidity.
Method
We performed a retrospective review of patients who underwent cardiac surgery over a 4-year period (2012-2015). Patients were stratified into three HbA1c groups (I = HbA1c 20-41 mmol/mol; II = HbA1c 42-48 mmol/mol; III = HbA1c 49-150 mmol/mol). Study end points were post-operative wound infection, stroke and renal failure. Chi-square test and independent sample t-test were performed to compare variables of interest.
Results
Among 1452 patients, 883 patients were in group I, 281 in group II and 288 in group III. There was statistically significant difference in post-operative wound infections between three groups (p < 0.006), with Group III having the highest rate of 7.6% while Group II 6.8% and Group I 3.5%. Patients with pre-operative HbA1c>42 mmol/mol (7.2% vs 3.5%) had a higher incidence of post-operative wound infections (p < 0.002; OR 2.134; 95% CI 1.322 - 3.445) when compared with Hb1Ac <42 mmol/mol. Patients with pre-operative HbA1c>;42 mmol/mol also had a significant increase in post-operative renal complications (p-value < 0.033; OR 2.569; 95%CI 1.049 - 6.290). Sub-group analysis among the urgent cases (n = 333) showed a 2.1 fold rise in wound infection (p < 0.02, OR 21, 95% CI 1.3-2.7). There was no statistical rise in incidence of stroke or mortality between the groups.
Discussion/Conclusion
Elevated Hb1Ac was associated with increased wound infections and risk of renal dysfunction after cardiac surgery. Patients undergoing urgent surgery with undiagnosed diabetes may remain at increased risk of post-operative wound infections.
Author information
Authors and Affiliations
Additional information
An erratum to this article is available at http://dx.doi.org/10.1186/s13019-017-0586-4.
Rights and permissions
Open Access  This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.
To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/.
The Creative Commons Public Domain Dedication waiver (https://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
About this article
Cite this article
Tee, A.H., Hasan, R., Mclaughlin, K. et al. Is pre-operative haemoglobin A1c level a successful predictor of adverse outcome after cardiac surgery?. J Cardiothorac Surg 10 (Suppl 1), A328 (2015). https://doi.org/10.1186/1749-8090-10-S1-A328
Published:
DOI: https://doi.org/10.1186/1749-8090-10-S1-A328