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
- PMID: 26138777
- DOI: 10.1016/j.hrtlng.2015.06.004
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.
Keywords: Cardiac surgery; Diabetes; Glycemic control; Insulin; Surgical site infection.
Copyright © 2015 Elsevier Inc. All rights reserved.
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