title: HbA1c predicts length of stay in patients admitted for coronary artery bypass surgery.
abstract: Diabetes mellitus is associated with coronary artery disease, and diabetic patients are frequently referred for coronary bypass graft surgery. It is well known that HbA1c, which reflects long-term glycemic control, is related to diabetic morbidity and mortality. It is not known whether HbA1c is related to postoperative length of stay among patients who undergo coronary artery bypass surgery. The authors evaluated 135 patients who underwent bypass surgery at the Westchester Medical Center (Valhalla, NY). HbA1c was measured in all patients preoperatively; a value of 7% or greater was used as a threshold for uncontrolled hyperglycemia. A postoperative length of stay of 6 days or more was used as the cutoff for an extended length of stay. Linear regression was used to assess the relationship between HbA1c, adjusted for age, and length of stay in days. Logistic regression, with length of stay a binary variable <6, > or =6 days, was used to assess the accuracy of HbA1c <7%, > or =7%, adjusted for age, in predicting length of stay. An HbA1c of 7% or greater was found to be a strong predictor of a length of stay of 6 days or longer. These data suggest that HbA1c can be used as a surrogate marker for cardiac and noncardiac morbidity that prolongs hospitalization after coronary artery bypass surgery.
authors.affiliation: Department of Medicine, New York Medical College and Westchester Medical Center, Valhalla, New York 10595, USA.
authors.forename: M
authors.initials: M
authors.lastname: Medhi
authors.forename: M C
authors.initials: MC
authors.lastname: Marshall
authors.forename: H B
authors.initials: HB
authors.lastname: Burke
authors.forename: R
authors.initials: R
authors.lastname: Hasan
authors.forename: D
authors.initials: D
authors.lastname: Nayak
authors.forename: G
authors.initials: G
authors.lastname: Reed
authors.forename: R
authors.initials: R
authors.lastname: LaFaro
authors.forename: A L
authors.initials: AL
authors.lastname: Southren
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000401:mortality; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000097:blood / Q000401:mortality; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008323:Mammary Arteries / Q000637:transplantation; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D010343:Patient Admission; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011237:Predictive Value of Tests
chemical_list: D006442:Glycated Hemoglobin