Elevated Hemoglobin A1c Is Associated With Lower Socioeconomic Position and Increased Postoperative Infections and Longer Hospital Stay After Cardiac Surgical Procedures

Finger, Brooke; Brase, Jason; He, Jia; Gibson, W; Wirtz, Katy; Flynn, Brigid C.

doi:10.1016/j.athoracsur.2016.05.092

Cited by 34 publications

(38 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the use of diabetes as a dichotomous variable does describe only chronic glycemic control, since the diagnosis is made by continuous blood glucose measurements or hemoglobin A1C measurements, which re ect average circulating glucose levels within120 days. Thus, glycosylated hemoglobin A1C has therefore been studied as a predictor of SSI risk [7][8][9][10][11][12][13]. Blood glucose, as the most direct indicator, is associated with the diagnosis of diabetes and glycosylated hemoglobin A1C.…”

Section: Univariate Analysismentioning

confidence: 99%

Analysis of influencing factors of incision infection in combined anterior-posterior surgery for subaxial cervical fracture dislocation

Li¹,

Wang²,

Hu³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: To explore the impact of related factors on the surgical site infection (SSI) after combined anterior-posterior surgery for subaxial cervical fracture dislocation (SCFD), and to provide a basis for formulating preventive measures.Methods: A total of 841 patients (531 males and 310 females, aged 24-68 years) with SCFD who received combined anterior-posterior surgery from January 2014 to May 2018 were retrospectively analyzed. According to whether the postoperative SSI occurred, they were divided into two groups. Demographic data, American spinal injury association (ASIA) neurological impairment scale, comorbidity, diet nursing and operating room related factors (time interval from skin preparation to operation, whether preoperative urinary catheterization was performed, whether was the consecutive operation, the total number of person in the operating room, operating room temperature, relative humidity, operational duration, and whether there was an intern nurse involved in the operation) the of patients in the two groups were analyzed by Logistic regression for the factors related to perioperative SSI. Result: SSI occurred in 44 patients with the rate of 5.2% (44/841). The results of univariate analysis showed that there were statistically significant differences between the two groups in the grade of ASIA scale, diabetes, lack of dietary care, time interval from skin preparation to operation, preoperative urinary catheterization, consecutive operation and the total number of person in the operating room (all P<0.01). Multivariable Logistic regression analysis results show that the severity of spinal cord injury (grade A OR value = 78.431, grade B OR value =24.120, grade C OR value = 5.342, P < 0.05, respectively), diabetes (OR value = 3.114, p=0.014), lack of dietary care (OR value = 2.275，p=0.023), time interval from skin preparation to operation > 6h (OR value = 2.342, p=0.022), preoperative urinary catheterization (OR value = 4.476, P <0.001) and the total number of person in the operating room > 8 (OR value = 2.921, P = 0.014) were positively correlated with perioperative SSI. Conclusion: The severity of spinal cord injury (ASIA grade A,B and C), diabetes, lack of dietary care, time interval from skin preparation to operation > 6 hours, preoperative urinary catheterization and the total number of person in the operating room > 8 are the risk factors for SSI after combined anterior-posterior surgery for SCFD.

show abstract

Section: Univariate Analysismentioning

confidence: 99%

Analysis of influencing factors of incision infection in combined anterior-posterior surgery for subaxial cervical fracture dislocation

Li¹,

Wang²,

Hu³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Indeed, poorly controlled diabetes was reported to be associated with an additional higher risk of surgical site infection (SSI) [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Long-term preoperative glycemic control restored the perioperative neutrophilic phagocytosis in diabetic mice.

Fujimoto

Nomura

Egi

et al. 2020

Preprint

View full text Add to dashboard Cite

BACKGROUND: The risk of surgical site infection has been reported to be higher in patients with poorly controlled diabetes. Since chronic hyperglycemia impairs neutrophil functions, preoperative glycemic control may restore neutrophil function. However, long-term insulin therapy may lead to a delay in surgery, which may be a problem, especially in cancer surgery. It is therefore unfortunate that　there have been few studies in which the optimal duration of perioperative glycemic control for diabetes with chronic hyperglycemia was investigated. Therefore, we investigated the effects of preoperative long-term insulin therapy and short-term insulin therapy on perioperative neutrophil functions in diabetic mice with chronic hyperglycemia. METHODS: Five-week-old male C57BL/6J mice were divided into four groups (Untreated (Diabetes Mellitus: DM), Short-term (DM), Long-term (DM), and Non-diabetic groups). Diabetes was established by administrating repeated low-dose streptozotocin. The Short-term (DM)group received insulin therapy for 6 hours before the operation and the Long-term (DM)group received insulin therapy for 5 days before the operation. The Untreated (DM) group and the Non-diabetic group did not receive insulin therapy. At 14 weeks of age, abdominal surgery with intestinal manipulation was performed in all four groups. We carried out a phagocytosis assay with fluorescent microspheres and a reactive oxygen species (ROS) production assay with DCFH-DA (2’,7’-dichlorodihydrofluorescein diacetate) before and 24 hours after the operation using FACSVerse™ with BD FACSuite™ software. RESULTS: Blood glucose was lowered by insulin therapy in the Short-term (DM) and Long-term (DM) groups before the operation. Neutrophilic phagocytosis activities before and after the operation were significantly restored in the Long-term (DM) group compared with those in the Untreated (DM) group (before: p = 0.0008, after: p = 0.0005). However, they were not significantly restored in the Short-term (DM) group. Neutrophilic ROS production activities before and after the operation were not restored in either the Short-term (DM) group or Long-term (DM) group. CONCLUSIONS: Preoperative and postoperative phagocytosis activities are restored by insulin therapy for 5 days before the operation but not by insulin therapy for 6 hours before the operation.

show abstract

“…The risk of postoperative infectious complications was shown to be significantly higher in patients with diabetes than in patients without diabetes [1]. Furthermore, poorly controlled diabetes was reported to be associated with an additional higher risk of surgical site infection (SSI) [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Impact of the duration of preoperative glycemic control on perioperative neutrophil functions in diabetic mice with chronic hyperglycemia: a laboratory research report

Fujimoto

Nomura

Egi

et al. 2020

Preprint

View full text Add to dashboard Cite

BACKGROUND: The risk of surgical site infection has been reported to be higher in patients with poorly controlled diabetes. Since chronic hyperglycemia impairs neutrophil functions, preoperative glycemic control may restore neutrophil function. However, long-term insulin therapy may lead to a delay in surgery, which may be a problem especially in cancer surgery. It is therefore unfortunate that there was no study to investigate the optimal duration of perioperative glycemic control for diabetes with chronic hyperglycemia. Therefore, we investigated the effects of preoperative long-term insulin therapy and short-term insulin therapy on perioperative neutrophil functions in diabetic mice with chronic hyperglycemia. METHODS: Five-week-old mice were administered streptozotocin to induce diabetes. We divided the diabetic mice into three groups: a group of mice with untreated diabetes (untreated group), a group of mice that received insulin therapy for 6 hours before surgery (short-term group) and a group of mice that received insulin therapy for 5 days before surgery (long-term group). A group of non-diabetic mice were used as a control group. At 14 weeks of age, abdominal surgery with intestinal manipulation was performed in all four groups. We carried out a phagocytosis assay by fluorescent microspheres and a reactive oxygen species (ROS) production assay by DCFH-DA (2’,7’-dichlorodihydrofluorescin diacetate) before and after surgery using FACSVerse™ with BD FACSuite™ software. Phagocytosis rate (%) was calculated by dividing the number of phagocytic beads by neutrophil count. Fluorescence from DCF (dichlorofluorescein) in the neutrophils was measured and expressed as mean fluorescence intensity (MFI). RESULTS: Blood glucose was lowered by insulin therapy in the short-term and long-term groups before the operation. Neutrophilic phagocytosis activities before and after the operation were significantly restored in the long-term group compared with those in the untreated group (before: p = 0.0008, after: p = 0.0005). However, they were not significantly restored in the short-term group. Neutrophilic ROS production activities before and after the operation were not restored in either the short-term group or long-term group. CONCLUSIONS: Preoperative and postoperative phagocytosis activities are restored by insulin therapy for 5 days before the operation but not by insulin therapy for 6 hours before the operation.

show abstract

Elevated Hemoglobin A1c Is Associated With Lower Socioeconomic Position and Increased Postoperative Infections and Longer Hospital Stay After Cardiac Surgical Procedures

Cited by 34 publications

References 34 publications

Analysis of influencing factors of incision infection in combined anterior-posterior surgery for subaxial cervical fracture dislocation

Analysis of influencing factors of incision infection in combined anterior-posterior surgery for subaxial cervical fracture dislocation

Long-term preoperative glycemic control restored the perioperative neutrophilic phagocytosis in diabetic mice.

Impact of the duration of preoperative glycemic control on perioperative neutrophil functions in diabetic mice with chronic hyperglycemia: a laboratory research report

Contact Info

Product

Resources

About