Key result
Age >65 years (OR 3.47) and cardiopulmonary bypass time >2 hours (OR 20.26) were identified as major risk factors for postoperative stress hyperglycemia in patients without diabetes following cardiac surgery.
Why the study?
Risk factors for stress-induced hyperglycemia in patients without diabetes after cardiac surgery required systematic evaluation.
Do specific clinical and procedural risk factors increase the risk of postoperative stress hyperglycemia in patients without diabetes following cardiac surgery?
Systematic Review (n=11,645)
Do specific clinical and procedural risk factors increase the risk of postoperative stress hyperglycemia in patients without diabetes following cardiac surgery?
In non-diabetic patients undergoing cardiac surgery, prolonged cardiopulmonary bypass time, advanced age, and combined surgical procedures are major risk factors for developing postoperative stress hyperglycemia.
Answers are grounded in this paper and cite their sources.
May identify high-risk non-diabetic patients after cardiac surgery; leaves open prospective validation before guiding practice.
Background: To systematically evaluate risk factors for stress-induced hyperglycemia in patients without diabetes after cardiac surgery. Methods: Databases including CNKI, WanFang data, VIP, SinoMed, PubMed, Web of Science, Embase, and the Cochrane Library were searched using computer retrieval. The data were subjected to an in-depth meta-analysis using RevMan 5.4 and Stata 15.0 software. Results: This study involved 11,645 postoperative cardiac surgery patients, including 8 case-control studies and 3 cohort studies, over which 18 risk factors were identified. The results of the meta-analysis indicated that statistically significant risk factors included age >65 years [odds ratios (OR) (95% CI ) = 3.47 (2.61-4.32)], female gender [OR (95%) = 1.54 (1.34-1.76)], combined heart valve and coronary artery bypass surgery [OR (95%) = 1.82 (1.23-2.70)], ejection fraction <40% [OR (95%) = 1.38 (1.17-1.63)], history of heart surgery [OR (95%) = 1.30 (1.06-1.59)], myocardial infarction [OR (95%) = 1.17 (1.05-1.31)], hyperlipidemia [OR (95%) = 0.76 (0.67-0.86)], hypertension [OR (95%) = 1.12 (1.03-1.22)], anticoagulant medication [OR (95%) = 0.77 (0.65-0.90)], cardiopulmonary bypass time >2 hours [OR (95%) = 20.26 (17.03-23.48)] and history of cardiopulmonary bypass [OR (95%) = 1.24 (1.09-1.41)]. Conclusions: Current evidence suggests that there are key risk factors for postoperative stress hyperglycemia in patients without diabetes who have undergone cardiac surgery. These factors can help identify patients at a high risk of perioperative stress hyperglycemia during cardiac surgery. This evidence provides a basis for healthcare professionals to develop predictive management strategies for perioperative stress hyperglycemia in patients without diabetes. However, more high-quality studies are required to address the limitations of the current research. The PROSPERO registration: CRD42024479215, https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=479215.
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Zhang et al. (2025) conducted a systematic review in Postoperative stress hyperglycemia (n=11,645). Age >65 years vs. Age ≤65 years was evaluated on Postoperative stress hyperglycemia (OR 3.47, 95% CI 2.61-4.32, p=<0.00001). Age >65 years (OR 3.47) and cardiopulmonary bypass time >2 hours (OR 20.26) were identified as major risk factors for postoperative stress hyperglycemia in patients without diabetes following cardiac surgery.
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