title: Prognostic significance of glycemic variability after cardiac surgery.
abstract: BACKGROUND
  The prognostic significance of acute glycemic variability (GV) after cardiac surgery is not known. This study was therefore planned to analyze the independent prognostic value of GV after cardiac surgery.
  
  
  METHODS
  This is a single center prospective observational study in 870 consecutive cardiac surgery patients over a 3-month period at a tertiary care institute in India.
  
  
  RESULTS
  In linear regression analysis, GV was a significant predictor of length of stay in intensive care unit (LOS-ICU) (beta 0.102, p=0.007) and rise in creatinine after surgery (beta 0.229, p<0.001). Mean POC-BG was a significant positive predictor of length of stay in hospital (LOS-hospital) (beta 0.1, p=0.004). In multivariable logistic regression analysis, GV predicted prolonged LOS-ICU (p=0.006, OR 1.016) and acute kidney injury (p<0.001, OR 1.034).
  
  
  CONCLUSIONS
  This study showed that GV, as measured by standard deviation, was a predictor of LOS-ICU, rise in creatinine and AKI after cardiac surgery. GV is therefore a new dimension in postoperative glycemic management in cardiac surgery patients, which needs to be explored.
authors.affiliation: Division of Endocrinology and Diabetes, Medanta, The Medicity. Electronic address: beenabansal1975@yahoo.co.in.
authors.forename: Beena
authors.initials: B
authors.lastname: Bansal
authors.affiliation: Gida, Bengaluru. Electronic address: pravincar@gmail.com.
authors.forename: Pravin
authors.initials: P
authors.lastname: Carvalho
authors.affiliation: Institute of Critical Care & Anaesthesiology, Medanta, the Medicity. Electronic address: yatin.mehta@medanta.org.
authors.forename: Yatin
authors.initials: Y
authors.lastname: Mehta
authors.affiliation: Division of Endocrinology and Diabetes, Medanta, The Medicity. Electronic address: jitenderyadav82@gmail.com.
authors.forename: Jitender
authors.initials: J
authors.lastname: Yadav
authors.affiliation: Cardiac Anesthesia, Medanta, the Medicity, Gurgaon. Electronic address: drprateek2412@gmail.com.
authors.forename: Prateek
authors.initials: P
authors.lastname: Sharma
authors.affiliation: Division of Endocrinology and Diabetes, Medanta, The Medicity. Electronic address: ambrish.mithal@medanta.org.
authors.forename: Ambrish
authors.initials: A
authors.lastname: Mithal
authors.affiliation: Heart Institute- Division of Cardio Thoracic & Vascular Surgery, Medanta, the Medicity. Electronic address: naresh.trehan@medanta.org.
authors.forename: Naresh
authors.initials: N
authors.lastname: Trehan
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000032:analysis; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D058065:Diabetic Cardiomyopathies / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D007003:Hypoglycemia / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D007194:India / Q000453:epidemiology; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012306:Risk; D062606:Tertiary Care Centers
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D003404:Creatinine
keywords: Cardiac surgery; Glycemic variability; Standard deviation