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    Relationship of perioperative hyperglycemia and major infections in cardiac surgery patients

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    Author
    Pear, Suzanne Marie
    Issue Date
    2004
    Keywords
    Health Sciences, Medicine and Surgery.
    Health Sciences, Public Health.
    Health Sciences, Health Care Management.
    Advisor
    Lebowitz, Michael D.
    
    Metadata
    Show full item record
    Publisher
    The University of Arizona.
    Rights
    Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
    Abstract
    Two of the major infectious complications of cardiac surgery are pneumonia and surgical site infections of the sternum and graft harvest site. These postoperative adverse events significantly increase patient morbidity, mortality and cost associated with coronary artery bypass graft operations. Pre-existing diabetes mellitus is commonly considered one of the primary risk factors for development of these major infections. However, most of the previous cardiac surgery risk factor studies have not considered the role perioperative stress hyperglycemia may play in initiating these complications. The primary hypothesis of this retrospective descriptive cohort study was that perioperative stress hyperglycemia (defined as either perioperative serum glucose threshold ≥250 mg/dL or perioperative serum glucose change ≥50 mg/dL) is an independent risk factor for the composite outcome of postoperative infections, including pneumonia and surgical site infections of the sternum and harvest site. The relationship of stress hyperglycemia to the individual infection outcomes was also examined. The secondary study hypothesis was that stress hyperglycemia increases resource utilization as excess days of care. The setting was a tertiary care federal medical facility in the southwestern United States, and the study cohort involved 1285 male military veterans.
    Type
    text
    Dissertation-Reproduction (electronic)
    Degree Name
    Ph.D.
    Degree Level
    doctoral
    Degree Program
    Graduate College
    Public Health
    Degree Grantor
    University of Arizona
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