Is elevated HbA1c a risk factor for infection after coronary artery bypass grafting surgery?

Deniz Göksedef, Suat Nail Ömeroğlu, Emine Şeyma Denli Yalvaç, Macit Bitargil, Gökhan İpek

Department of Cardiovascular Surgery, Medicine Faculty of Cerrahpaşa University, İstanbul

Background: The effect of glycosylated hemoglobin (HbA1c) and perioperative glucose levels on short term results following coronary artery bypass grafting surgery were compared.

Methods: One hundred and fifty patients (106 males, 44 females; mean age 61.69±10.06 years; range 37 to 84 years), who underwent coronary artery bypass grafting surgery in our clinic between April 2007 and December 2008, were enrolled in this study prospectively. Every patient including non-diabetics were managed with Portland protocol in the perioperative period.

Results: Mediastinitis was observed in two patients (1.3%). Elevated HbA1c levels do not affect the short term infectious complications, however the patients who had elevated perioperative glucose levels had higher incidence (0 vs 3%, p=0.01) of mediastinitis and local sternal infection (2.3% vs 12.1%, p=0.002).

Conclusion: Poor perioperative glucose management affects and increases the rate of postoperative infections as expected but elevated HbA1c levels do not cause any risks in infectious complications following coronary artery bypass grafting surgery.

Keywords : Coronary artery bypass grafting surgery; glycosylated hemoglobin; Hemoglobin A1c; infection

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