title: The effectiveness of tight glycemic control on decreasing surgical site infections and readmission rates in adult patients with diabetes undergoing cardiac surgery: A systematic review.
abstract: OBJECTIVE
  A systematic review of the effects of tight glycemic control with a continuous insulin infusion to achieve blood glucose levels ≤ 200 mg/dL on surgical site infections and readmission rates in adult patients with diabetes after cardiac surgery.
  
  
  METHODS
  A quantitative systematic review of the literature. Databases, including PubMed, CINAHL, EMBASE, and CENTRAL, were searched for relevant studies from database inception through August 2014. Randomized and quasi-experimental studies were included.
  
  
  RESULTS
  A meta-analysis of ten studies demonstrated that glycemic control with a continuous insulin infusion to achieve blood glucose levels ≤ 200 mg/dL significantly reduced surgical site infection rates (odds ratio 0.35, 95% confidence interval 0.25-0.49; Z = 6.0, P < 0.00001) compared with standard diabetes management.
  
  
  CONCLUSIONS
  Maintaining blood glucose levels ≤ 200 mg/dL with a continuous insulin infusion in all stages of the perioperative period in cardiac surgery patients with diabetes can reduce the incidence of surgical site infections.
authors.affiliation: Pace University, College of Health Professions, Lienhard School of Nursing, 163 William Street, 5th Floor, New York, NY 10038, USA.
authors.forename: Lyn
authors.initials: L
authors.lastname: Boreland
authors.affiliation: Pace University, College of Health Professions, Lienhard School of Nursing, 163 William Street, 5th Floor, New York, NY 10038, USA.
authors.forename: Marcia
authors.initials: M
authors.lastname: Scott-Hudson
authors.affiliation: Pace University, College of Health Professions, Lienhard School of Nursing, 163 William Street, 5th Floor, New York, NY 10038, USA.
authors.forename: Kathy
authors.initials: K
authors.lastname: Hetherington
authors.affiliation: Pace University, College of Health Professions, Lienhard School of Nursing, 163 William Street, 5th Floor, New York, NY 10038, USA.
authors.forename: Antoinette
authors.initials: A
authors.lastname: Frussinetty
authors.affiliation: Pace University, College of Health Professions, Lienhard School of Nursing, 163 William Street, 5th Floor, New York, NY 10038, USA. Electronic address: jslyer@pace.edu.
authors.forename: Jason T
authors.initials: JT
authors.lastname: Slyer
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D006348:Cardiac Surgical Procedures; D003920:Diabetes Mellitus / Q000097:blood* / Q000188:drug therapy; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D007332:Insulin Infusion Systems; D016017:Odds Ratio; D010359:Patient Readmission / Q000706:statistics & numerical data*; D013530:Surgical Wound Infection / Q000517:prevention & control*
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Cardiac surgery; Diabetes; Glycemic control; Insulin; Surgical site infection