Association Between Perioperative Glycemic Control Strategy and Mortality in Patients With Diabetes Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis
To analyze association between different perioperative glycemic control strategies and postoperative outcomes in patients with diabetes undergoing cardiac surgery. MEDLINE, Cochrane Library, Web of Science, EMBASE, Wanfang Data, China National Knowledge Infrastructure (CNKI) and China Biology Medici...
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| Veröffentlicht in: | Frontiers in endocrinology (Lausanne) 2020-12, Vol.11, p.513073-513073 |
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| container_title | Frontiers in endocrinology (Lausanne) |
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| creator | Jin, Xinye Wang, Jinjing Ma, Yanfang Li, Xueqiong An, Ping Wang, Jie Mao, Wenfeng Mu, Yiming Chen, Yaolong Chen, Kang |
| description | To analyze association between different perioperative glycemic control strategies and postoperative outcomes in patients with diabetes undergoing cardiac surgery.
MEDLINE, Cochrane Library, Web of Science, EMBASE, Wanfang Data, China National Knowledge Infrastructure (CNKI) and China Biology Medicine (CBM) databases were searched from inception to January 31, 2019. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias of included studies, and consensus was reached by discussion with a third researcher.
Six RCTs were included in the meta-analysis. We analyzed the effect of liberal (>180 mg/dl or 10.0 mmol/L), moderate (140-180 mg/dl or 7.8-10.0 mmol/L) and strict ( |
| doi_str_mv | 10.3389/fendo.2020.513073 |
| format | Article |
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MEDLINE, Cochrane Library, Web of Science, EMBASE, Wanfang Data, China National Knowledge Infrastructure (CNKI) and China Biology Medicine (CBM) databases were searched from inception to January 31, 2019. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias of included studies, and consensus was reached by discussion with a third researcher.
Six RCTs were included in the meta-analysis. We analyzed the effect of liberal (>180 mg/dl or 10.0 mmol/L), moderate (140-180 mg/dl or 7.8-10.0 mmol/L) and strict (<140 mg/dl or 7.8 mmol/L) glycemic control strategies in patients with diabetes undergoing cardiac surgery. The pooled results showed that strict glycemic control strategy was associated with a significant reduction in the risk of atrial fibrillation [OR = 0.48, 95%CI (0.32, 0.72),
< 0.001] and sternal wound infection [OR = 0.28, 95%CI (0.14, 0.54),
< 0.001], while there was no significant differences in postoperative mortality, stroke, and hypoglycemic episodes when compared with moderate control. In addition, there is no significant difference between moderate and liberal glycemic control strategies in postoperative mortality. However, moderate control was beneficial in reducing atrial fibrillation [OR = 0.28, 95%CI (0.13, 0.60),
= 0.001] compared with the liberal glycemic control strategy.
This meta-analysis showed when compared with moderate glycemic control strategy in patients with diabetes undergoing cardiac surgery, maintained strict glycemic control was associated with lower risk of atrial fibrillation and sternal wound infection. No benefit was found with liberal glycemic control strategy, so it could be a poor glycemic control strategy.</description><identifier>ISSN: 1664-2392</identifier><identifier>EISSN: 1664-2392</identifier><identifier>DOI: 10.3389/fendo.2020.513073</identifier><identifier>PMID: 33391180</identifier><language>eng</language><publisher>Switzerland: Frontiers Media S.A</publisher><subject>cardiac surgery ; diabetes ; Endocrinology ; meta-analysis ; perioperative glycemic control ; systematic review</subject><ispartof>Frontiers in endocrinology (Lausanne), 2020-12, Vol.11, p.513073-513073</ispartof><rights>Copyright © 2020 Jin, Wang, Ma, Li, An, Wang, Mao, Mu, Chen and Chen.</rights><rights>Copyright © 2020 Jin, Wang, Ma, Li, An, Wang, Mao, Mu, Chen and Chen 2020 Jin, Wang, Ma, Li, An, Wang, Mao, Mu, Chen and Chen</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c465t-8cf5408f170e8bf4735a99a724e4ed45febc8eae26b2865245d90cb53bcf288e3</citedby><cites>FETCH-LOGICAL-c465t-8cf5408f170e8bf4735a99a724e4ed45febc8eae26b2865245d90cb53bcf288e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774648/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774648/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,27903,27904,53770,53772</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33391180$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jin, Xinye</creatorcontrib><creatorcontrib>Wang, Jinjing</creatorcontrib><creatorcontrib>Ma, Yanfang</creatorcontrib><creatorcontrib>Li, Xueqiong</creatorcontrib><creatorcontrib>An, Ping</creatorcontrib><creatorcontrib>Wang, Jie</creatorcontrib><creatorcontrib>Mao, Wenfeng</creatorcontrib><creatorcontrib>Mu, Yiming</creatorcontrib><creatorcontrib>Chen, Yaolong</creatorcontrib><creatorcontrib>Chen, Kang</creatorcontrib><title>Association Between Perioperative Glycemic Control Strategy and Mortality in Patients With Diabetes Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis</title><title>Frontiers in endocrinology (Lausanne)</title><addtitle>Front Endocrinol (Lausanne)</addtitle><description>To analyze association between different perioperative glycemic control strategies and postoperative outcomes in patients with diabetes undergoing cardiac surgery.
MEDLINE, Cochrane Library, Web of Science, EMBASE, Wanfang Data, China National Knowledge Infrastructure (CNKI) and China Biology Medicine (CBM) databases were searched from inception to January 31, 2019. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias of included studies, and consensus was reached by discussion with a third researcher.
Six RCTs were included in the meta-analysis. We analyzed the effect of liberal (>180 mg/dl or 10.0 mmol/L), moderate (140-180 mg/dl or 7.8-10.0 mmol/L) and strict (<140 mg/dl or 7.8 mmol/L) glycemic control strategies in patients with diabetes undergoing cardiac surgery. The pooled results showed that strict glycemic control strategy was associated with a significant reduction in the risk of atrial fibrillation [OR = 0.48, 95%CI (0.32, 0.72),
< 0.001] and sternal wound infection [OR = 0.28, 95%CI (0.14, 0.54),
< 0.001], while there was no significant differences in postoperative mortality, stroke, and hypoglycemic episodes when compared with moderate control. In addition, there is no significant difference between moderate and liberal glycemic control strategies in postoperative mortality. However, moderate control was beneficial in reducing atrial fibrillation [OR = 0.28, 95%CI (0.13, 0.60),
= 0.001] compared with the liberal glycemic control strategy.
This meta-analysis showed when compared with moderate glycemic control strategy in patients with diabetes undergoing cardiac surgery, maintained strict glycemic control was associated with lower risk of atrial fibrillation and sternal wound infection. No benefit was found with liberal glycemic control strategy, so it could be a poor glycemic control strategy.</description><subject>cardiac surgery</subject><subject>diabetes</subject><subject>Endocrinology</subject><subject>meta-analysis</subject><subject>perioperative glycemic control</subject><subject>systematic review</subject><issn>1664-2392</issn><issn>1664-2392</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>DOA</sourceid><recordid>eNpVks9u1DAQxiMEolXpA3BBPnLJ4vhPYnNAWhYolYpALBVHa-JMUlfZeLG9W-WBeE_cbqlaX2zNzPfz6NNXFK8ruuBc6Xc9Tp1fMMroQlacNvxZcVzVtSgZ1-z5o_dRcRrjNc1H0Epr9bI44pzrqlL0uPi7jNFbB8n5iXzEdIM4kR8YnN9iyNU9krNxtrhxlqz8lIIfyTrlDg4zgakj33xIMLo0E5eFWYFTiuS3S1fkk4MWE0ZyOXUYBu-mgawgdA4sWe_CgGF-T5ZkPceEm6y05CfuHd4cuJigXE4wztHFV8WLHsaIp_f3SXH55fOv1dfy4vvZ-Wp5UVpRy1Qq20tBVV81FFXbi4ZL0BoaJlBgJ2SPrVUIyOqWqVoyITtNbSt5a3umFPKT4vzA7Txcm21wGwiz8eDMXcGHwUDIi45oOgu9zu5qDlZg9pW1UmgFDUjaMdtm1ocDa7trN9jZ7EuA8Qn0aWdyV2bwe9M0jaiFyoC394Dg_-wwJrNx0eI4woR-Fw0TjaRK1pLn0eowaoOPMWD_8E1FzW1azF1azG1azCEtWfPm8X4Piv_Z4P8AAUHAkQ</recordid><startdate>20201217</startdate><enddate>20201217</enddate><creator>Jin, Xinye</creator><creator>Wang, Jinjing</creator><creator>Ma, Yanfang</creator><creator>Li, Xueqiong</creator><creator>An, Ping</creator><creator>Wang, Jie</creator><creator>Mao, Wenfeng</creator><creator>Mu, Yiming</creator><creator>Chen, Yaolong</creator><creator>Chen, Kang</creator><general>Frontiers Media S.A</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20201217</creationdate><title>Association Between Perioperative Glycemic Control Strategy and Mortality in Patients With Diabetes Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis</title><author>Jin, Xinye ; Wang, Jinjing ; Ma, Yanfang ; Li, Xueqiong ; An, Ping ; Wang, Jie ; Mao, Wenfeng ; Mu, Yiming ; Chen, Yaolong ; Chen, Kang</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c465t-8cf5408f170e8bf4735a99a724e4ed45febc8eae26b2865245d90cb53bcf288e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>cardiac surgery</topic><topic>diabetes</topic><topic>Endocrinology</topic><topic>meta-analysis</topic><topic>perioperative glycemic control</topic><topic>systematic review</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jin, Xinye</creatorcontrib><creatorcontrib>Wang, Jinjing</creatorcontrib><creatorcontrib>Ma, Yanfang</creatorcontrib><creatorcontrib>Li, Xueqiong</creatorcontrib><creatorcontrib>An, Ping</creatorcontrib><creatorcontrib>Wang, Jie</creatorcontrib><creatorcontrib>Mao, Wenfeng</creatorcontrib><creatorcontrib>Mu, Yiming</creatorcontrib><creatorcontrib>Chen, Yaolong</creatorcontrib><creatorcontrib>Chen, Kang</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Frontiers in endocrinology (Lausanne)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jin, Xinye</au><au>Wang, Jinjing</au><au>Ma, Yanfang</au><au>Li, Xueqiong</au><au>An, Ping</au><au>Wang, Jie</au><au>Mao, Wenfeng</au><au>Mu, Yiming</au><au>Chen, Yaolong</au><au>Chen, Kang</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association Between Perioperative Glycemic Control Strategy and Mortality in Patients With Diabetes Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis</atitle><jtitle>Frontiers in endocrinology (Lausanne)</jtitle><addtitle>Front Endocrinol (Lausanne)</addtitle><date>2020-12-17</date><risdate>2020</risdate><volume>11</volume><spage>513073</spage><epage>513073</epage><pages>513073-513073</pages><issn>1664-2392</issn><eissn>1664-2392</eissn><abstract>To analyze association between different perioperative glycemic control strategies and postoperative outcomes in patients with diabetes undergoing cardiac surgery.
MEDLINE, Cochrane Library, Web of Science, EMBASE, Wanfang Data, China National Knowledge Infrastructure (CNKI) and China Biology Medicine (CBM) databases were searched from inception to January 31, 2019. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias of included studies, and consensus was reached by discussion with a third researcher.
Six RCTs were included in the meta-analysis. We analyzed the effect of liberal (>180 mg/dl or 10.0 mmol/L), moderate (140-180 mg/dl or 7.8-10.0 mmol/L) and strict (<140 mg/dl or 7.8 mmol/L) glycemic control strategies in patients with diabetes undergoing cardiac surgery. The pooled results showed that strict glycemic control strategy was associated with a significant reduction in the risk of atrial fibrillation [OR = 0.48, 95%CI (0.32, 0.72),
< 0.001] and sternal wound infection [OR = 0.28, 95%CI (0.14, 0.54),
< 0.001], while there was no significant differences in postoperative mortality, stroke, and hypoglycemic episodes when compared with moderate control. In addition, there is no significant difference between moderate and liberal glycemic control strategies in postoperative mortality. However, moderate control was beneficial in reducing atrial fibrillation [OR = 0.28, 95%CI (0.13, 0.60),
= 0.001] compared with the liberal glycemic control strategy.
This meta-analysis showed when compared with moderate glycemic control strategy in patients with diabetes undergoing cardiac surgery, maintained strict glycemic control was associated with lower risk of atrial fibrillation and sternal wound infection. No benefit was found with liberal glycemic control strategy, so it could be a poor glycemic control strategy.</abstract><cop>Switzerland</cop><pub>Frontiers Media S.A</pub><pmid>33391180</pmid><doi>10.3389/fendo.2020.513073</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | cardiac surgery diabetes Endocrinology meta-analysis perioperative glycemic control systematic review |
| title | Association Between Perioperative Glycemic Control Strategy and Mortality in Patients With Diabetes Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis |
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