ASSOCIATION OF PREOPERATIVE HBA1C LEVEL WITH STERNAL WOUND INFECTION IN DIABETIC PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTING
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Keywords
HbA1c, diabetes mellitus, CABG, sternal wound infection, postoperative infection.
Abstract
Background: Sternal wound infection (SWI) is a serious postoperative complication after coronary artery bypass grafting (CABG), particularly in diabetic patients. Poor glycemic control may delay wound healing and increase infection risk.
Objective: This study aimed to compare the frequency of sternal wound infection in diabetic patients with normal and raised HbA1c levels after CABG.
Methods: A descriptive case series was conducted at the Department of Adult Cardiac Surgery, AFIC/NIHD, Rawalpindi, from 30 April 2019 to 1 November 2019. A total of 370 diabetic patients undergoing elective CABG were included and divided into two equal groups: 185 patients with normal HbA1c and 185 patients with raised HbA1c. Patients were followed for 21 postoperative days for evidence of sternal wound infection. Data were analyzed using SPSS version 23, and p ≤ 0.05 was considered significant. Results: The overall frequency of sternal wound infection was 5.13% (19/370). Infection occurred in 4 patients (2.16%) with normal HbA1c and 15 patients (8.10%) with raised HbA1c. The difference was statistically significant (p = 0.001). The highest infection rate was observed in patients with HbA1c ≥ 8% (21.42%).
Conclusion: Raised HbA1c is significantly associated with a higher frequency of sternal wound infection after CABG in diabetic patients. Preoperative HbA1c assessment and glycemic optimization may help reduce postoperative wound complications.
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Yasir Naseem
Trainee Registrar, Department of Gastroenterology, Postgraduate Medical Institute (PGMI), Lady Reading Hospital, Peshawar, Pakistan
Faiq Ahmed Khan
Trainee Registrar, Department of Gastroenterology, Postgraduate Medical Institute (PGMI), Lady Reading Hospital, Peshawar, Pakistan
