The prognostic value of postoperative blood glucose in non-diabetic patients with rheumatic heart disease
Abstract Background Blood glucose (BG) is a risk factor of adverse prognosis in non-diabetic patients in several conditions. However, a limited number of studies were performed to explore the relationship between postoperative BG and adverse outcomes in non-diabetic patients with rheumatic heart dis...
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doaj-98e6c419e08e45fc806a3f8d9459e5782020-12-20T12:18:23ZengBMCBMC Cardiovascular Disorders1471-22612019-12-011911710.1186/s12872-019-01278-2The prognostic value of postoperative blood glucose in non-diabetic patients with rheumatic heart diseaseWan-zi Hong0Yu Wang1Hongjiao Yu2Xue-biao Wei3Danqing Yu4Chun-xiang Zhang5Ning Tan6Lei Jiang7Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesDepartment of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesInstitute of Medical Sciences, School of Medical Sciences, University of AberdeenGuangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesDepartment of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesSchool of Medicine, University of Alabama at BirminghamDepartment of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesGuangdong Provincial Geriatrics Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical SciencesAbstract Background Blood glucose (BG) is a risk factor of adverse prognosis in non-diabetic patients in several conditions. However, a limited number of studies were performed to explore the relationship between postoperative BG and adverse outcomes in non-diabetic patients with rheumatic heart disease (RHD). Methods We identified 1395 non-diabetic patients who diagnosed with having RHD, and underwent at least one valve replacement and preoperative coronary angiography. BG was measured at admission to the intensive care unit (ICU) after surgery. The association of postoperative BG level with in-hospital and one-year mortality was accordingly analyzed. Results Included patients were stratified into four groups according to postoperative BG level’s (mmol/L) quartiles: Q1 (< 9.3 mmol/L, n = 348), Q2 (9.3–10.9 mmol/L, n = 354), Q3 (10.9–13.2 mmol/L, n = 341), and Q4 (≥ 13.2 mmol/L, n = 352). The in-hospital death (1.1% vs. 2.3% vs. 1.8% vs. 8.2%, P < 0.001) and MACEs (2.0% vs. 3.1% vs. 2.6% vs. 9.7%, P < 0.001) were significantly higher in the upper quartiles. Postoperative BG > 13.0 mmol/L was the best threshold for predicting in-hospital death (area under the curve (AUC) = 0.707, 95% confidence interval (CI): 0.634–0.780, P < 0.001). Multivariate logistic regression analysis indicated that postoperative BG > 13.0 mmol/L was an independent predictor of in-hospital mortality (adjusted odds ratio (OR) = 3.418, 95% CI: 1.713–6.821, P < 0.001). In addition, Kaplan–Meier curve analysis showed that the risk of one-year death was increased for a postoperative BG > 13.2 (log-rank = 32.762, P < 0.001). Conclusion Postoperative BG, as a routine test, could be served as a risk measure for non-diabetic patients with RHD.https://doi.org/10.1186/s12872-019-01278-2Rheumatic heart diseaseValve replacement surgeryBlood glucoseIn-hospital death |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Wan-zi Hong Yu Wang Hongjiao Yu Xue-biao Wei Danqing Yu Chun-xiang Zhang Ning Tan Lei Jiang |
spellingShingle |
Wan-zi Hong Yu Wang Hongjiao Yu Xue-biao Wei Danqing Yu Chun-xiang Zhang Ning Tan Lei Jiang The prognostic value of postoperative blood glucose in non-diabetic patients with rheumatic heart disease BMC Cardiovascular Disorders Rheumatic heart disease Valve replacement surgery Blood glucose In-hospital death |
author_facet |
Wan-zi Hong Yu Wang Hongjiao Yu Xue-biao Wei Danqing Yu Chun-xiang Zhang Ning Tan Lei Jiang |
author_sort |
Wan-zi Hong |
title |
The prognostic value of postoperative blood glucose in non-diabetic patients with rheumatic heart disease |
title_short |
The prognostic value of postoperative blood glucose in non-diabetic patients with rheumatic heart disease |
title_full |
The prognostic value of postoperative blood glucose in non-diabetic patients with rheumatic heart disease |
title_fullStr |
The prognostic value of postoperative blood glucose in non-diabetic patients with rheumatic heart disease |
title_full_unstemmed |
The prognostic value of postoperative blood glucose in non-diabetic patients with rheumatic heart disease |
title_sort |
prognostic value of postoperative blood glucose in non-diabetic patients with rheumatic heart disease |
publisher |
BMC |
series |
BMC Cardiovascular Disorders |
issn |
1471-2261 |
publishDate |
2019-12-01 |
description |
Abstract Background Blood glucose (BG) is a risk factor of adverse prognosis in non-diabetic patients in several conditions. However, a limited number of studies were performed to explore the relationship between postoperative BG and adverse outcomes in non-diabetic patients with rheumatic heart disease (RHD). Methods We identified 1395 non-diabetic patients who diagnosed with having RHD, and underwent at least one valve replacement and preoperative coronary angiography. BG was measured at admission to the intensive care unit (ICU) after surgery. The association of postoperative BG level with in-hospital and one-year mortality was accordingly analyzed. Results Included patients were stratified into four groups according to postoperative BG level’s (mmol/L) quartiles: Q1 (< 9.3 mmol/L, n = 348), Q2 (9.3–10.9 mmol/L, n = 354), Q3 (10.9–13.2 mmol/L, n = 341), and Q4 (≥ 13.2 mmol/L, n = 352). The in-hospital death (1.1% vs. 2.3% vs. 1.8% vs. 8.2%, P < 0.001) and MACEs (2.0% vs. 3.1% vs. 2.6% vs. 9.7%, P < 0.001) were significantly higher in the upper quartiles. Postoperative BG > 13.0 mmol/L was the best threshold for predicting in-hospital death (area under the curve (AUC) = 0.707, 95% confidence interval (CI): 0.634–0.780, P < 0.001). Multivariate logistic regression analysis indicated that postoperative BG > 13.0 mmol/L was an independent predictor of in-hospital mortality (adjusted odds ratio (OR) = 3.418, 95% CI: 1.713–6.821, P < 0.001). In addition, Kaplan–Meier curve analysis showed that the risk of one-year death was increased for a postoperative BG > 13.2 (log-rank = 32.762, P < 0.001). Conclusion Postoperative BG, as a routine test, could be served as a risk measure for non-diabetic patients with RHD. |
topic |
Rheumatic heart disease Valve replacement surgery Blood glucose In-hospital death |
url |
https://doi.org/10.1186/s12872-019-01278-2 |
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