Authors: Finger B, Brase J, He J, Gibson WJ, Wirtz K, Flynn BC
Ann Thorac Surg. 2017 Jan;103(1):145-151
BACKGROUND: Patients with elevated hemoglobin A1c (HbA1c) levels have an increased risk of adverse short- and long-term outcomes after cardiac surgical procedures. Whether elevated HbA1c levels are associated with lower socioeconomic position (SEP) has been unknown.
METHODS: All adult patients undergoing cardiac surgical procedures at Kansas University Medical Center in Kansas City, Kansas in 2014 (nÂ = 567) were reviewed. Of those patients, 531 had a preoperative HbA1c level measured. HbA1c was delineated as 7% or lower or greater than 7%. The two aims of this study were to evaluate a possible association of HbA1c and SEP and to evaluate for a possible association of HbA1c levels and poor outcomes after cardiac surgical procedures. The primary postsurgical outcomes were infections and intensive care unit length of stay.
RESULTS: HbA1c levels greater than 7% were associated with lower SEP (pÂ = 0.005) and with increased risk of infection postoperatively (p < 0.001). Total hospital length of stay tended to be longer for patients with HbA1c greater than 7% (pÂ = 0.009).
CONCLUSIONS: Elevated HbA1c levels are associated with lower SEP. This association not only may hinder the ability to correct HbA1c levels, but also may impart a risk for elevated HbA1c levels. Additionally, patients who present for cardiac operations with HbA1c greaterÂ than 7% have an increased risk of postoperative infections.