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Impact of intraoperative hyperglycaemia on renal dysfunction after off-pump coronary artery bypass

DC Field Value Language
dc.contributor.author곽영란-
dc.contributor.author송종욱-
dc.contributor.author심재광-
dc.contributor.author오세영-
dc.contributor.author유경종-
dc.date.accessioned2014-12-18T09:05:19Z-
dc.date.available2014-12-18T09:05:19Z-
dc.date.issued2013-
dc.identifier.issn1569-9293-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/87511-
dc.description.abstractOBJECTIVES: Acute kidney injury (AKI) is one of the most frequently occurring complications after off-pump coronary artery bypass graft (OPCAB). Hyperglycaemia is a major, potentially modifiable risk factor of adverse outcome after cardiac surgery known to aggravate organ damage. The aim of this study was to address the association between intraoperative glucose concentration and postoperative AKI in patients who underwent OPCAB. METHODS: The medical records of 880 consecutive patients were retrospectively reviewed. Patients were divided into three groups according to the time-weighted average of intraoperative glucose concentrations (<110, 110-150 and >150 mg/dl), and the incidence of AKI (increase of serum creatinine to >2.0 mg/dl and 2 × most recent preoperative value or a new requirement for dialysis) was compared. Multivariate logistic regression analysis was performed to identify independent risk factors for postoperative AKI. RESULTS: The incidence of AKI was higher in patients with a glucose level >150 mg/dl than in patients with a glucose level = 110-150 mg/dl [8% (20 of 251) vs 3% (14 of 453), P = 0.004]. On multivariate analysis, glucose >150 mg/dl (odds ratio [OR], 2.78; 95% confidence interval [CI], 1.12-6.86, P = 0.027), coefficient of variation of glucose (OR, 1.04; 95% CI, 1.01-1.07, P = 0.027) and preoperative serum creatinine >1.4 mg/dl (OR, 8.81; 95% CI, 3.90-19.9, P < 0.001) were identified as independent risk factors for postoperative AKI. CONCLUSIONS: Intraoperative glucose concentration >150 mg/dl and increased variability of glucose were independently associated with AKI after OPCAB. Tight intraoperative glycaemic control (<110 mg/dl) does not seem to provide additional benefit in terms of AKI.-
dc.description.statementOfResponsibilityopen-
dc.relation.isPartOfINTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAcute Kidney Injury/blood-
dc.subject.MESHAcute Kidney Injury/diagnosis-
dc.subject.MESHAcute Kidney Injury/etiology*-
dc.subject.MESHAged-
dc.subject.MESHBiomarkers/blood-
dc.subject.MESHBlood Glucose/metabolism-
dc.subject.MESHChi-Square Distribution-
dc.subject.MESHCoronary Artery Bypass, Off-Pump/adverse effects*-
dc.subject.MESHCreatinine/blood-
dc.subject.MESHDrug Administration Schedule-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHHyperglycemia/blood-
dc.subject.MESHHyperglycemia/diagnosis-
dc.subject.MESHHyperglycemia/drug therapy-
dc.subject.MESHHyperglycemia/etiology*-
dc.subject.MESHHypoglycemic Agents/administration & dosage-
dc.subject.MESHInsulin Lispro/administration & dosage-
dc.subject.MESHIntraoperative Period-
dc.subject.MESHLogistic Models-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHMultivariate Analysis-
dc.subject.MESHOdds Ratio-
dc.subject.MESHPostoperative Period-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHRisk Factors-
dc.subject.MESHTime Factors-
dc.subject.MESHTreatment Outcome-
dc.titleImpact of intraoperative hyperglycaemia on renal dysfunction after off-pump coronary artery bypass-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Anesthesiology (마취통증의학)-
dc.contributor.googleauthorJong Wook Song-
dc.contributor.googleauthorJae Kwang Shim-
dc.contributor.googleauthorKyung Jong Yoo-
dc.contributor.googleauthorSe Young Oh-
dc.contributor.googleauthorYoung Lan Kwak-
dc.identifier.doi10.1093/icvts/ivt209-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA00172-
dc.contributor.localIdA02060-
dc.contributor.localIdA02205-
dc.contributor.localIdA02377-
dc.contributor.localIdA02453-
dc.relation.journalcodeJ01070-
dc.identifier.eissn1569-9285-
dc.identifier.pmid23690431-
dc.identifier.urlhttp://icvts.oxfordjournals.org/content/17/3/473.long-
dc.subject.keywordAcute kidney injury-
dc.subject.keywordCoronary artery bypass-
dc.subject.keywordHyperglycaemia-
dc.subject.keywordOff pump-
dc.contributor.alternativeNameKwak, Young Lan-
dc.contributor.alternativeNameSong, Jong Wook-
dc.contributor.alternativeNameShim, Jae Kwang-
dc.contributor.alternativeNameOh, Se Young-
dc.contributor.alternativeNameYoo, Kyung Jong-
dc.contributor.affiliatedAuthorKwak, Young Lan-
dc.contributor.affiliatedAuthorSong, Jong Wook-
dc.contributor.affiliatedAuthorShim, Jae Kwang-
dc.contributor.affiliatedAuthorOh, Se Young-
dc.contributor.affiliatedAuthorYoo, Kyung Jong-
dc.rights.accessRightsnot free-
dc.citation.volume17-
dc.citation.number3-
dc.citation.startPage473-
dc.citation.endPage478-
dc.identifier.bibliographicCitationINTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY, Vol.17(3) : 473-478, 2013-
dc.identifier.rimsid34273-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers

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