Investigation of the Effect of Acute to Chronic Glycemic Ratio on the Development of Postoperative Pneumonia After Stanford Type A Acute Aortic Dissection Surgery

Yıl 2023, Cilt: 5 Sayı: 1, 140 - 5, 15.01.2023

Orhan Güvenç , Mesut Engin , Senol Yavuz

https://doi.org/10.37990/medr.1185908

Öz

Aim: A critical clinical condition called acute Type A aortic dissection (ATAAD) necessitates quick surgical action. Other significant issues include the emergence of postoperative pneumonia and various organ failures. We sought to determine how well the ratio of admission blood glucose (ABG) to estimated average glucose (eAG) might be used to anticipate postoperative pneumonia following ATAAD surgery.
Materials and Methods: The study comprised patients who underwent ATAAD surgery between January 2016 and January 2022. In the postoperative phase, patients were divided into two groups: Group 1 for those who did not acquire pneumonia and Group 2 for those who did.
Results: The study involved 124 patients in total. Group 1 [N = 92, median age = 51 (32 to 80) years] consisted of those who did not acquire postoperative pneumonia, but Group 2 [N = 32, median age = 53 (30 to 77)] did. ABG/eAG ratio and ventilation time were found to be independent predictors of postoperative pneumonia by multivariate analysis [(OR: 0.886, CI 95%: 0.695-0.990, P=0.009) and (OR: 1.114, 1.030-1.542, P=0.023)].
Conclusion: We demonstrated that ABG/eAG ratio, calculated at admission time, is a significant predictor of the development of postoperative pneumonia.

Anahtar Kelimeler

Type A acute aortic dissection, glucose, risk factor, pneumonia

Kaynakça

• 1. Engin M, Göncü MT, Güvenç O, et al. Tip A Aort Diseksiyonlarında Operasyon Sonrası Erken Dönem Mortalite ve Morbidite Üzerine Etki Eden Faktörlerin Retrospektif İncelenmesi. Dicle Med Journal. 2018;45:387-96.
• 2. Wei J, Chen Z, Zhang H, et al. In-hospital major adverse outcomes of acute Type A aortic dissection. Eur J Cardiothorac Surg. 2019;55:345-50.
• 3. Gao S, Liu Q, Ding X, et al. Predictive Value of the Acute-to-Chronic Glycemic Ratio for In-Hospital Outcomes in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention. Angiology. 2020;71:38-47.
• 4. Şimşek B, Çınar T, Ozan V, et al. The association of acute--to—chronic glycemic ratio with no-reflow in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Kardiol Pol. 2021;79:170-8.
• 5. Lin L, Lin Y, Peng Y, et al. Admission Hyperglycemia in Acute Type A Aortic Dissection Predicts for a Prolonged Duration of Mechanical Ventilation. Int Heart J. 2022;63:106-12.
• 6. Likosky DS, Harrington SD, Cabrera L, et al. Collaborative Quality Improvement Reduces Postoperative Pneumonia After Isolated Coronary Artery Bypass Grafting Surgery. Circ Cardiovasc Qual Outcomes 2018;11:e004756.
• 7. Elsayed RS, Cohen RG, Fleischman F and Bowdish ME. Acute Type A Aortic Dissection. Cardiol Clin. 2017;35:331-45.
• 8. Eitel I, HintzeS, de Waha S, et al. Prognostic impact of hyperglycemia in nondiabetic and diabetic patients with ST-elevation myocardial infarction: insights from contrast-enhanced magnetic resonance imaging. Circ Cardiovasc Imaging. 2012;5:708–18.
• 9. Worthley MI, Holmes AS, Willoughby SR, et al. The deleterious effects of hyperglycemia on platelet function in diabetic patients with acute coronary syndromes mediation by superoxide production, resolution with intensive insülin administration. J Am Coll Cardiol. 2007;49:304–10.
• 10. Ishihara M, Kagawa E, Inoue I, et al. Impact of admission hyperglycemia and diabetes mellitus on short- and long-term mortality after acute myocardial infarction in the coronary intervention era. Am J Cardiol. 2007;99:1674–79.
• 11. Kewcharoen J, Ali M, Trongtorsak A, et al. Admission hyperglycemia is associated with reperfusion failure in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention: a systematic review and meta-analysis. Am J Cardiovasc Dis. 2021;11:348-59.
• 12. Anderson BM, Wise BT, Joshi M, et al. Admission Hyperglycemia Is a Risk Factor for Deep Surgical-Site Infection in Orthopaedic Trauma Patients. J Orthop Trauma. 2021;35:e451-e7.
• 13. Sia CH, Chan MH, Zheng H, et al. Optimal glucose, HbA1c, glucose-HbA1c ratio and stress-hyperglycaemia ratio cut-off values for predicting 1-year mortality in diabetic and non-diabetic acute myocardial infarction patients. Cardiovasc Diabetol. 2021;20:211.
• 14. Gao S, Liu Q, Chen H, et al. Predictive value of stress hyperglycemia ratio for the occurrence of acute kidney injury in acute myocardial infarction patients with diabetes. BMC Cardiovasc Disord. 2021;21:157.
• 15. Mondal S, DasGupta R, Lodh M, et al. Stress hyperglycemia ratio, rather than admission blood glucose, predicts in-hospital mortality and adverse outcomes in moderate-to severe COVID-19 patients, irrespective of pre-existing glycemic status. Diabetes Res Clin Pract. 2022;190:109974.
• 16. Chen G, Li M, Wen X, et al. Association Between Stress Hyperglycemia Ratio and In-hospital Outcomes in Elderly Patients With Acute Myocardial Infarction. Front Cardiovasc Med. 2021;8:698725.
• 17. Wang D, Huang X, Wang H, et al. Risk factors for postoperative pneumonia after cardiac surgery: a prediction model. J Thorac Dis. 2021;13:2351-62.
• 18. Wang D, Abuduaini X, Huang X, et al. Development and validation of a risk prediction model for postoperative pneumonia in adult patients undergoing Stanford type A acute aortic dissection surgery: a case control study. J Cardiothorac Surg. 2022;17:22.
• 19. Yao R, Liu X, He Y, et al. Low platelet count is a risk factor of postoperative pneumonia in patients with type A acute aortic dissection. J Thorac Dis. 2020;12:2333-42.