Key result
Perioperatively treated adrenal insufficiency in cardiothoracic surgery patients was associated with a higher rate of hyperglycemia requiring insulin infusion.
Why the study?
The association between adrenal insufficiency and treatment outcomes in cardiothoracic surgery patients has been little reported.
Does preoperative adrenal insufficiency screening and perioperative glucocorticoid treatment improve post-surgical outcomes in cardiothoracic surgery patients?
Cohort (n=98)
Does preoperative adrenal insufficiency screening and perioperative glucocorticoid treatment improve post-surgical outcomes in cardiothoracic surgery patients?
Answers are grounded in this paper and cite their sources.
Proper diagnosis and management of adrenal insufficiency in cardiothoracic surgery patients yields surgical outcomes comparable to those with normal adrenal function, though with an increased risk of hyperglycemia.
Background: The association between adrenal insufficiency (AI) and the treatment outcomes of cardiothoracic surgery patients has been little reported. The aims of this study were to investigate the incidence of AI and to compare the post-surgical outcomes of patients with perioperatively treated AI and patients with a normal adrenal response. Methods: A 1.5-year prospective study was conducted in 98 patients scheduled for cardiothoracic surgery. Patients were categorized as either AI or normal-adrenal-response patients. Those with AI were treated with stress doses of glucocorticoid perioperatively. The post-surgical outcomes of patients with AI and of those with a normal adrenaline response were analyzed using multivariable analysis. Results: The overall incidence of AI was 34.7%. There were no statistically significant differences in post-surgical outcomes, including prolonged hospital stay, postoperative infection, prolonged inotropic drug use and relative AI, between the two groups. Only the rate of hyperglycemia requiring insulin infusion was significantly higher in the AI group than in the non-AI group (OR = 14.15, 95% CI = 1.44–138.60, p = 0.02). Conclusions: The proper diagnosis and management of AI can result in surgical outcomes in AI patients comparable to those of normal-adrenal-response patients. Non-life-threatening hyperglycemia requiring insulin infusion was found only in the AI group.
No takes yet. Share an insight, caveat, or question.
Manosroi et al. (2023) conducted a cohort in Scheduled for cardiothoracic surgery (n=98). Adrenal insufficiency treated with perioperative stress doses of glucocorticoid vs. Normal adrenal response was evaluated on Hyperglycemia requiring insulin infusion (OR 14.15, 95% CI 1.44-138.60, p=0.02). Perioperatively treated adrenal insufficiency in cardiothoracic surgery patients was associated with a higher rate of hyperglycemia requiring insulin infusion.
Synapse has enriched 10 related papers. Consider them for comparative context: