Glycemic control in diabetic and non-diabetic cardiac surgical patients and length of hospital stay.

Background: Maintaining blood glucose levels (BGL) within normoglycemic range has been shown to reduce morbidity and mortality in critically ill patients. However, there is little evidence that maintenance of normoglycemic BGL is beneficial for diabetic and non-diabetic patients who undergo cardiac surgery.

Purpose: To examine the relationship between BGL and length of stay (LOS) of cardiac surgical patients.

Methods: Data were obtained from the Safer Healthcare Now Project database in the cardiovascular intensive care unit (CVICU) at the Foothills Medical Centre, Calgary, Alberta, and included two BGL from cardiac surgery patients: BGL 1 was collected within four hours preoperatively, BGL 2 was collected postoperatively 24 hours after BGL 1. CVICU LOS and total hospital LOS were obtained from the Tracer database of the Department of Critical Care Medicine, Calgary Health Region. Demographic, clinical, and surgical data were collected from health records.

Results: For the 398 patients, no relationship was found between pre- and postoperative BGL and LOS. Although pre- and postoperative BGL were not different between diabetics and non-diabetics, diabetics had longer CVICU LOS and total hospital LOS. Age, preoperative HgbA1C, type of surgery, cross-clamp and cardiopulmonary bypass times, APACHE II scores, and postoperative complications also affected LOS.

Conclusion: In this cohort of cardiac surgical patients, pre- and postoperative BGL did not affect LOS.