Publication Type

Journal Article

Version

publishedVersion

Publication Date

2-2024

Abstract

Background: Deep sternal wound infection (DSWI) constitutes a serious complication after coronary artery bypass grafting (CABG) surgery. The aim of this study is to evaluate the dose-response relationship between glycated hemoglobin (HbA1c) level and the risk of DSWI after CABG. Methods: PubMed, Scopus, and Cochrane Library databases were searched to identify potentially relevant articles. According to rigorous inclusion and exclusion criteria, fourteen studies including 15,570 patients were finally enrolled in our meta-analysis. Odds ratio (OR) with 95% confidence intervals (CIs) was used as the summary statistic. The robust-error meta-regression model was used to synthesize the dose-response relationship. Results: Our meta-analysis shows that among patients undergoing CABG, preoperative elevated HbA1c was associated with the risk of developing DSWI (OR = 2.67, 95% CI 2.00–3.58) but with low prognostic accuracy (diagnostic OR = 2.70, 95% CI 1.96–3.73; area under the curve = 0.66, 95% CI 0.62–0.70) for predicting postoperative DSWI. Subgroup analyses showed the relationship became nonsignificant in patients without diabetes and studies adopting lower HbA1c thresholds. Dose-response analysis showed a significant nonlinear (p = 0.03) relationship between HbA1c and DSWI, with a significantly increased risk of DSWI when HbA1c was >5.7%.ConclusionsAn elevated HbA1c level of >5.7% is related to a higher risk of developing DSWI after CABG, and the risk is increasing as the HbA1c level grows. The association between HbA1c and DSWI was nonsignificant among nondiabetic patients while significant among diabetic patients.

Keywords

HbA1c, deep sternal wound infection, DSWI, CABG, dose-response, meta-analysis

Discipline

Medical Sciences | Operations and Supply Chain Management

Research Areas

Operations Management

Publication

Journal of Cardiothoracic Surgery

Volume

19

First Page

1

Last Page

9

ISSN

1749-8090

Identifier

10.1186/s13019-024-02549-6

Publisher

BioMed Central

Copyright Owner and License

Authors

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Additional URL

https://doi.org/10.1186/s13019-024-02549-6

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