Prognostic significance of glycemic variability after cardiac surgery

Introduction: 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. Materials and 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). Conclusion: 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. (C) 2016 Elsevier Inc. All rights reserved.