What is the clinical evidence from this study?

Study design: Cohort. Population: Cardiac surgery (n=157). Intervention: Blood glucose target compliance (70-180 mg/dL) vs. Non-compliance. Primary outcome: In-hospital mortality (OR 0.10, 95% CI 0.02-0.59, p=0.011).

What does this research mean for the field?

Compliance with a moderate blood glucose target (70-180 mg/dL) is associated with lower in-hospital mortality after cardiac surgery. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study assesses the impact of perioperative glycemic levels on infection and mortality following cardiac surgery.

May 27, 2026

Perioperative Glycemic Control and Outcomes in Cardiac Surgery: A Retrospective Cohort Study.

Key Result

Compliance with a moderate blood glucose target (70-180 mg/dL) was associated with lower in-hospital mortality (OR 0.10; 95% CI 0.02-0.59; P=0.011) after cardiac surgery.

Key Points

This study assesses the impact of perioperative glycemic levels on infection and mortality following cardiac surgery.
Included consecutive adult patients undergoing cardiac surgery (N=157) between January 2021 and December 2022.
Defined glycemic exposure based on glucose measurements from anesthesia induction to discharge or death.
Used multivariable logistic regression to find associations between glycemic control and outcomes.
Postoperative infection occurred in 59.9% (n=94) of patients, and in-hospital mortality was 8.9% (n=14).
Blood glucose target compliance was 78.3%, associated with lower in-hospital mortality (OR 0.10, 95% CI 0.02-0.59; P=0.011).
Hyperglycemia (>180 mg/dL) was linked to a higher risk of postoperative infection (OR 3.77, 95% CI 1.38-10.35; P=0.010).

Study Design

Type

Cohort (n=157)

Multicenter

Structured PICO

Does compliance with a moderate blood glucose target (70-180 mg/dL) reduce postoperative infection and in-hospital mortality in patients undergoing cardiac surgery?

Population

157 consecutive adult patients (mean age 59.7±13.0 years) who underwent elective or emergency cardiac surgery between January 2021 and December 2022 at a tertiary cardiovascular center in Brazil.

Intervention

Perioperative glycemic exposure, specifically compliance with a blood glucose target (BGT) of 70 to 180 mg/dL in ≥70% of measurements, or presence of hyperglycemia (>180 mg/dL) / hypoglycemia (<70 mg/dL).

Comparator

Non-compliance with the blood glucose target, or absence of hyperglycemia/hypoglycemia.

Outcome

Postoperative infection and in-hospital mortality.hard clinical

Maintaining perioperative blood glucose within 70-180 mg/dL is associated with significantly lower in-hospital mortality, while hyperglycemia >180 mg/dL increases the risk of postoperative infection in cardiac surgery patients.

Main Result

Effect estimate: OR 0.10 (95% CI 0.02-0.59)

p-value: p=0.011

Limitations

Hypothesis-generating
Needs confirmation in larger prospective studies

Abstract

BACKGROUND Perioperative hyperglycemia is a common metabolic response to surgical stress and has been shown to be associated with adverse outcomes after cardiac surgery. However, the optimal glycemic target in this setting remains uncertain, since both hyperglycemia and hypoglycemia can be harmful. This study aimed to evaluate the association between perioperative glucose levels and postoperative infection and in-hospital mortality in patients undergoing cardiac surgery at a tertiary cardiovascular center. MATERIAL AND METHODS This study included consecutive adult patients who underwent elective or emergency cardiac surgery between January 2021 and December 2022 at a tertiary cardiovascular center in Brazil. Perioperative glycemic exposure was defined using all glucose measurements recorded from anesthesia induction until hospital discharge or in-hospital death. Compliance with the blood glucose target (BGT) was defined as values within 70 to 180 mg/dL in ≥70% of measurements. Hypoglycemia and hyperglycemia were defined as at least 1 glucose measurement 180 mg/dL, respectively. Primary outcomes were postoperative infection and in-hospital mortality. Multivariable logistic regression was used to identify independent associations. RESULTS A total of 157 patients were included (mean age 59.7±13.0 years). Postoperative infection occurred in 59.9% (n=94), and in-hospital mortality occurred in 8.9% (n=14). BGT compliance was observed in 78.3% of patients. Hypoglycemia occurred in 31.8%, and hyperglycemia in 82.8%. BGT compliance was independently associated with lower in-hospital mortality (OR 0.10, 95% CI 0.02-0.59; P=0.011). At least one episode of hyperglycemia was independently associated with postoperative infection (OR 3.77, 95% CI 1.38-10.35; P=0.010). CONCLUSIONS Perioperative glycemic patterns were associated with clinically relevant outcomes after cardiac surgery. Compliance with a moderate blood glucose target range (70-180 mg/dL) was associated with lower in-hospital mortality, whereas hyperglycemia >180 mg/dL was associated with postoperative infection. These findings should be interpreted as hypothesis-generating and need confirmation in larger prospective studies.

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