Hyperglycemia after cardiac surgery: improving a quality measure

AACN Adv Crit Care. 2014 Jul-Sep;25(3):221-7. doi: 10.1097/NCI.0000000000000028.

Abstract

Background: The Surgical Care Improvement Project #4 (SCIP#4) performance measure is used to evaluate achievement of target blood glucose control after cardiac surgery.

Objectives: The purpose of this study was to identify patient characteristics and outcomes in patients undergoing cardiac surgery who met the SCIP#4 performance measure versus those who did not.

Methods: A retrospective case-control design was used.

Results: Preoperative hemoglobin A1C (HbA1C) level and history of diabetes were 2 major risk factors for failing to meet the SCIP#4 measure. A trend toward a longer length of stay was observed, mortality was 3 times more prevalent, and renal failure was 4 times more frequent in patients who did not meet the SCIP#4 quality measure.

Conclusions: Not meeting the SCIP#4 measure is associated with adverse outcomes. History of diabetes and preoperative HbAIC level should be considered when evaluating strategies for managing postsurgical hyperglycemia.

MeSH terms

  • Aged
  • Blood Glucose / analysis
  • Case-Control Studies
  • Female
  • Humans
  • Hyperglycemia / etiology*
  • Male
  • Retrospective Studies
  • Thoracic Surgical Procedures / adverse effects*

Substances

  • Blood Glucose