A study of a pre-operative intervention in patients with diabetes undergoing cardiac surgery

Geraldine Anne Lee, Sue Wyatt, Duncan J Topliss, Karen Zell Walker, Rachel M Stoney

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10 Citations (Scopus)

Abstract

Background: Coronary heart disease is common in Type 2 diabetes and often requires cardiac surgery. However poorer outcomes have been reported including increased rates of post-operative infection and prolonged hospital stay. Aim: The aim of the study was to determine the feasibility and acceptability of a specialist consultation model (pre-operative medical and educational intervention) for type 2 diabetes in the cardiac surgery setting. Methods: Twenty four patients were assigned usual care or to the intervention group. The intervention group were assessed by a diabetes clinical nurse consultant, dietitian, and endocrinologist during a pre-operative visit. Specific diabetes questionnaires were administered, education was delivered, and protocol-driven changes to the medical regimen were instituted. Length of stay, incidence of post-operative complications, and number of post-operative inpatient review endocrinology visits required were recorded. Results: Twenty four patients with a pre-operative HbA1c greater than 6.5 (48mmol/mol) were studied (17 males and 7 females). In the usual care group (n=15), HbA1c pre-operatively was 7.2 (55.2mmol/mol) compared to 10.1 (86.9mmol/mol) in the intervention group (n=9). Six weeks post-operatively HbA1c fell significantly in the intervention group by 1.9 (to 8.2 [66.1mmol/mol]) compared to a reduction of 1.2 (to 7.0 [53mmol/mol]) in the usual care group (p
Original languageEnglish
Pages (from-to)287 - 293
Number of pages7
JournalCollegian
Volume21
Issue number4
DOIs
Publication statusPublished - 2014

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