Coronary artery by pass graftingearly morbidity and mortality in patients with tight glycaemic control versus standard control

ABSTRACT

Several studies have suggested superiority of tight glycaemic control in reducing the incidence of surgical site infection and mortality after cardiac surgery. To compare the frequency of post operative surgical site infections after CABG in patients with tight glycamic control and those with standard glycamic control. Shaikh Zayed Hospital, Lahore. June 2008 to March 2010. Total of 496 patients were included, they were randomized to tight glycaemic control group [TGC, n =248] or standard control group[SC, n=248].In TGC group blood glucose was maintained between 90 - 130 mg/dl, while in SC group blood glucose was maintained between 131- 190mg/dl for 48 hours post surgery. Results were prospectively evaluated. Demographic and surgical data was similar in both groups. Patients in TGC group showed significant reduction in post operative superficial sternal wound infection [4 vs 12, p < 0.05], deep sternal wound infection [1 vs 7, p <0.05] and leg wound infection [2vs 9, p<0.05].There was also non significant reduction in the incidence of post operative mediastinitis [1 vs 3], new myocardial infarction [2 vs 3],and atrial fibrillation [10 vs 12]. Mortality was equal in both groups [1 in each]. Significant reduction in SSI was observed in TGC group and no change was seen in other morbidities and short term mortality in the study