OBJECTIVE: The management of postoperative @entity4854 is controversial and generally does not take into account pre-existing @entity6 . We analyzed clinical and economic outcomes associated with postoperative @entity4854 in cardiac surgery @entity1 , stratifying by @entity6 status. RESEARCH DESIGN AND METHODS: Multicenter cohort study in 4,316 cardiac surgery @entity1 operated on in 2010. @entity413 was measured at 6-h intervals for 48 h postoperatively. Outcomes included cost, hospital length of stay (LOS), @entity299 , @entity281 , and @entity204 . Associations between maximum @entity413 levels and outcomes were assessed with multivariable regression and recycled prediction analyses. RESULTS: In @entity1 without @entity6 , increasing @entity413 levels were associated with a gradual worsening of outcomes. In these @entity1 , @entity4854 (>= 180 mg/dL) was associated with an additional cost of  3,192 (95% CI  1,972- 4,456), an additional hospital LOS of 0.8 days (0.4-1.3 days), an increase in infections of 1.6% (0.5-2.8%), and an @entity1576 .6% (0.0-5.3%). However, among @entity1 with insulin-treated @entity6 , optimal outcomes were associated with @entity413 levels considered to be @entity1602 (180-240 mg/dL). This level of @entity4854 was associated with cost reductions of  6,225 (- 12,886 to - 222), hospital LOS reductions of 1.6 days (-3.7 to 0.4), @entity281 .1% (-9.1% to 0.0%), and reductions in respiratory complication of 12.5% (-22.4% to -3.0%). In @entity1 with @entity2175 , outcomes did not differ significantly when @entity4854 was present. CONCLUSIONS: @entity413 levels <180 mg/dL are associated with better outcomes in most @entity1 , but worse outcomes in @entity1 with @entity6 with a history of prior insulin use. These findings support further investigation of a stratified approach to the management of @entity1 with stress-induced postoperative @entity4854 based on prior @entity6 status.

XXXX and the Association of Postoperative Hyperglycemia With Clinical and Economic Outcomes in Cardiac Surgery.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity2175 :: ('MESH:D003924', 'Disease') :: ['non-insulin-treated diabetes'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetes'] @entity1602 :: ('MESH:D006944', 'Disease') :: ['hyperglycemic'] @entity281 :: ('MESH:D007239', 'Disease') :: ['infection reductions of 4', 'major infections'] @entity1576 :: ('MESH:D012131', 'Disease') :: ['increase in respiratory complications of 2'] @entity299 :: ('MESH:D006331', 'Disease') :: ['cardiac and respiratory complications'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity4854 :: ('MESH:D006943', 'Disease') :: ['hyperglycemia'] @entity413 :: ('MESH:D005947', 'Chemical') :: ['glucose', 'Glucose']
@entity6 :: (MESH:D003920,Disease) :: ['Diabetes']
