title: Predictors of hyperglycemia after cardiac surgery in nondiabetic patients.
abstract: OBJECTIVE
  Postoperative hyperglycemia is associated with poor clinical outcomes in patients undergoing cardiac surgery. However, some experts consider hyperglycemia to be an epiphenomenon related to acute stress. We investigated whether preoperative patient characteristics can predict hyperglycemia after cardiac surgery in nondiabetic patients.
  
  
  METHODS
  This is a retrospective study of nondiabetic patients undergoing cardiac surgery at a single center during the years 2004 to 2009. Hyperglycemia was defined as 2 consecutive blood glucose readings of 150 mg/dL or greater during the 72 hours after cardiac surgery.
  
  
  RESULTS
  This study included 1453 patients with hyperglycemia and 2205 patients without hyperglycemia. Hyperglycemic patients were older, were more likely to be men, had higher body mass index, were more likely to be hypertensive and hypercholesterolemic, and had lower left ventricular ejection fractions; in addition, a greater proportion had a history of cardiovascular disease and renal failure. Multivariate logistic regression analysis showed age, gender, body mass index, preoperative serum creatinine, left ventricular ejection fraction, previous cardiac surgery, and preoperative cardiogenic shock to be independently associated with hyperglycemia (P < .05 for all). Hyperglycemic patients had more intraoperative and postoperative complications.
  
  
  CONCLUSIONS
  Preoperative patient characteristics are associated with hyperglycemia after cardiac surgery.
authors.affiliation: Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, Mass. Electronic address: rgarg@partners.org.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Garg
authors.affiliation: Division of Endocrinology, Diabetes and Hypertension, Brigham and Women's Hospital, Boston, Mass.
authors.forename: Anjali
authors.initials: A
authors.lastname: Grover
authors.affiliation: Division of Cardiac Surgery, Brigham and Women's Hospital, Boston, Mass.
authors.forename: Siobhan
authors.initials: S
authors.lastname: McGurk
authors.affiliation: Division of Cardiac Surgery, Brigham and Women's Hospital, Boston, Mass.
authors.forename: James D
authors.initials: JD
authors.lastname: Rawn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D015331:Cohort Studies; D003920:Diabetes Mellitus; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies