title: Association of blood glucose levels with in-hospital mortality and 30-day readmission in patients undergoing invasive cardiovascular surgery.
abstract: OBJECTIVE
  This study aimed to evaluate the association of mean and maximum blood glucose (BG) levels with in-hospital mortality and 30-day hospital readmission among patients in the intensive care unit (ICU) undergoing invasive cardiovascular (CV) surgery.
  
  
  METHODS
  The retrospective database analysis consisted of data from 3132 patients from 17 hospitals who underwent an invasive CV surgery during 1/2000-12/2006. Patients with hyperglycemia were identified based on serum BG levels recorded from 12 hours prior to and 24 hours after ICU admission. Separate logistic regression models were used to examine the association of mean and maximum BG levels to in-hospital mortality and 30-day readmission, adjusting for patient demographics, comorbidities and laboratory values.
  
  
  RESULTS
  The adjusted odds ratio (OR) for in-hospital mortality was 1.07 (95% CI: 1.01-1.12; p < .001) for every 0.56-mmol/L increase in mean BG, and OR = 1.06 (95% CI: 1.03-1.08, p < .001) for every 0.56-mmol/L increase in maximum BG. Mean BG was not associated with 30-day readmission while maximum BG had a borderline association: OR = 1.02 (95% CI: 1.00-1.03, p = .06).
  
  
  CONCLUSIONS
  The results are not generalizable to all cardiovascular surgical patients since only those undergoing invasive procedures were included in the study.
  
  
  CONCLUSIONS
  Higher mean and maximum BG levels were associated with increased risk of in-hospital mortality but not with 30-day readmission. Further research is needed to identify optimal BG targets and the effects of avoiding extreme hyperglycemia on patient outcomes.
authors.affiliation: Eli Lilly and Company, Indianapolis, IN, USA.
authors.forename: Lauren J
authors.initials: LJ
authors.lastname: Lee
authors.forename: Matthew F
authors.initials: MF
authors.lastname: Emons
authors.forename: Sherry A
authors.initials: SA
authors.lastname: Martin
authors.forename: Douglas
authors.initials: D
authors.lastname: Faries
authors.forename: Jay
authors.initials: J
authors.lastname: Bae
authors.forename: Brian H
authors.initials: BH
authors.lastname: Nathanson
authors.forename: Hsing-Ting
authors.initials: HT
authors.lastname: Yu
authors.forename: Tracy
authors.initials: T
authors.lastname: Haidar
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Bode
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D013504:Cardiovascular Surgical Procedures; D016208:Databases, Factual; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000401:mortality; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D001786:Blood Glucose