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Background: Blood glucose (BG) is a risk factor of adverse prognosis in non-diabetic patients in several conditions. However, a limited number of studies were performed to explore the relationship between postoperative BG and adverse outcomes in non-diabetic patients with rheumatic heart disease (RHD) undergoing valve replacement surgery (VRS). Methods: We identified 1395 non-diabetic patients who diagnosed with having RHD, and underwent preoperative coronary angiography and at least one valve replacement. BG was measured at admission to the intensive care unit (ICU) after surgery. The association of postoperative BG level with in-hospital and one-year mortality was accordingly analyzed. Results: Included patients were stratified into four groups according to postoperative BG level’s (mmol/L) quartiles: Q1 (< 9.3 mmol/L, n=348), Q2 (9.3-10.9 mmol/L, n=354), Q3 (10.9-13.2 mmol/L, n=341), and Q4 (≥ 13.2 mmol/L, n=352). The in-hospital death (1.1% vs. 2.3% vs. 1.8% vs. 8.2%, P<0.001) and MACEs (2.0% vs. 3.1% vs. 2.6% vs. 9.7%, P<0.001) were significantly higher in the upper quartiles. Postoperative BG > 13.0 mmol/L was the best threshold for predicting in-hospital death (area under the curve (AUC) = 0.707, 95% confidence interval (CI): 0.634-0.780, P<0.001). Multivariate logistic regression analysis indicated that postoperative BG > 13.0 mmol/L was an independent predictor of in-hospital mortality (adjusted odds ratio (OR) = 3.418, 95% CI: 1.713–6.821, P<0.001). In addition, Kaplan–Meier curve analysis showed that the risk of one-year death was increased for a postoperative BG > 13.2 (log-rank = 32.762, P<0.001). Conclusion: Postoperative BG, as a routine test, could be served as a risk-stratified measure for non-diabetic patients with RHD.
Keywords
rheumatic heart disease; valve replacement surgery; blood glucose; in-hospital death
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Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Cardiovascular Disorders.
No community comments so far
Editorial decision: Accept
On 26 Nov, 2019
Reviewer #2 agreed
On 05 Nov, 2019
Review #2 received
Received 05 Nov, 2019
Reviewer #1 agreed
On 04 Nov, 2019
Review #1 received
Received 04 Nov, 2019
Reviewers invited
Invitations sent on 03 Nov, 2019
Editor assigned
On 31 Oct, 2019
Submission checks complete
On 30 Oct, 2019
Editor invited
On 30 Oct, 2019
Version 1
Posted 10 Sep, 2019
No comments provided
Editorial decision: Minor revision
On 17 Oct, 2019
Review #1 received
Received 09 Oct, 2019
Review #2 received
Received 09 Oct, 2019
Reviewer #1 agreed
On 04 Oct, 2019
Reviewer #2 agreed
On 04 Oct, 2019
Reviewers invited
Invitations sent on 15 Sep, 2019
Editor assigned
On 09 Sep, 2019
Submission checks complete
On 06 Sep, 2019
Editor invited
On 06 Sep, 2019
First submitted
On 21 Aug, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cardiac & Cardiovascular Systems
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A new preprint design is coming!
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See the published version of this preprint at BMC Cardiovascular Disorders.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Cardiovascular Disorders.
No community comments so far
Editorial decision: Accept
On 26 Nov, 2019
Reviewer #2 agreed
On 05 Nov, 2019
Review #2 received
Received 05 Nov, 2019
Reviewer #1 agreed
On 04 Nov, 2019
Review #1 received
Received 04 Nov, 2019
Reviewers invited
Invitations sent on 03 Nov, 2019
Editor assigned
On 31 Oct, 2019
Submission checks complete
On 30 Oct, 2019
Editor invited
On 30 Oct, 2019
Version 1
Posted 10 Sep, 2019
No comments provided
Editorial decision: Minor revision
On 17 Oct, 2019
Review #1 received
Received 09 Oct, 2019
Review #2 received
Received 09 Oct, 2019
Reviewer #1 agreed
On 04 Oct, 2019
Reviewer #2 agreed
On 04 Oct, 2019
Reviewers invited
Invitations sent on 15 Sep, 2019
Editor assigned
On 09 Sep, 2019
Submission checks complete
On 06 Sep, 2019
Editor invited
On 06 Sep, 2019
First submitted
On 21 Aug, 2019
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Cardiac & Cardiovascular Systems
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Cardiovascular Disorders.
Background: Blood glucose (BG) is a risk factor of adverse prognosis in non-diabetic patients in several conditions. However, a limited number of studies were performed to explore the relationship between postoperative BG and adverse outcomes in non-diabetic patients with rheumatic heart disease (RHD) undergoing valve replacement surgery (VRS). Methods: We identified 1395 non-diabetic patients who diagnosed with having RHD, and underwent preoperative coronary angiography and at least one valve replacement. BG was measured at admission to the intensive care unit (ICU) after surgery. The association of postoperative BG level with in-hospital and one-year mortality was accordingly analyzed. Results: Included patients were stratified into four groups according to postoperative BG level’s (mmol/L) quartiles: Q1 (< 9.3 mmol/L, n=348), Q2 (9.3-10.9 mmol/L, n=354), Q3 (10.9-13.2 mmol/L, n=341), and Q4 (≥ 13.2 mmol/L, n=352). The in-hospital death (1.1% vs. 2.3% vs. 1.8% vs. 8.2%, P<0.001) and MACEs (2.0% vs. 3.1% vs. 2.6% vs. 9.7%, P<0.001) were significantly higher in the upper quartiles. Postoperative BG > 13.0 mmol/L was the best threshold for predicting in-hospital death (area under the curve (AUC) = 0.707, 95% confidence interval (CI): 0.634-0.780, P<0.001). Multivariate logistic regression analysis indicated that postoperative BG > 13.0 mmol/L was an independent predictor of in-hospital mortality (adjusted odds ratio (OR) = 3.418, 95% CI: 1.713–6.821, P<0.001). In addition, Kaplan–Meier curve analysis showed that the risk of one-year death was increased for a postoperative BG > 13.2 (log-rank = 32.762, P<0.001). Conclusion: Postoperative BG, as a routine test, could be served as a risk-stratified measure for non-diabetic patients with RHD.
Figure 1
Figure 2
Figure 3
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