Practitioner dashboard feedback improves glycemic but not temperature compliance during cardiac surgery: A single center retrospective analysis - 11/09/24
, Natalia Egorova, PhD b, Yuxia Ouyang, PhD b, Amanda J. Rhee, MD, MS a, Joseph Larese, MD aAbstract |
Study Objective |
To determine the association of practitioner dashboard feedback of intraoperative glycemic and temperature control on maintenance of normoglycemia and normothermia.
Design |
Retrospective review.
Setting |
Single tertiary care institution.
Patients |
Patients over the age of 18 undergoing cardiac surgery from February 17, 2021 through February 16, 2023. During the study interval, 15 anesthesiologists providing care during 2255 procedures were analyzed: 1114 prior to the individual faculty dashboard distribution and 1141 after commencement of dashboard distribution.
Interventions |
On February 17, 2022, anesthesia faculty members began receiving monthly individualized dashboards indicating their personal intraoperative glycemic and temperature compliance rates.
Measurements |
Baseline patient demographic characteristics, surgical and cardiopulmonary bypass times, perioperative temperature and glucose concentrations, and the incidence of sternal wound infections. Glycemic compliance was defined as final serum glucose between 80 and 180 mg/dL. Temperature compliance was defined as an average temperature during the final 30 min of the surgical procedure between 35 and 37.3 °C inclusive.
Main results |
Dashboard distribution was associated with a significant decrease in the average glucose concentration (median location shift by −6 mg% (95% confidence interval (CI) -8, −4), p < 0.001) from 157 mg/dL to 152 mg/dL and final glucose concentration (median location shift by −17 mg/dL (95% CI -19, −14, p < 0.001) from 161 mg/dL to 145 mg/dL. The intervention was associated with an improvement in glycemic compliance from 71.4% to 87.1% (odds ratio (OR): 2.71(95% CI 2.19, 3.37, p < 0.001)). There were no significant differences in final temperature (36.3 °C [Q1, Q3: 36.0, 36.6] vs. 36.3 °C [Q1, Q3: 36.0, 36.7] (p = 0.232)) with the intervention nor were there any statistically significant differences in temperature compliance (93.9% vs. 92.9%, OR: 0.79 (95% CI 0.55–1.14, p = 0.25). There were no statistically significant changes in the incidence of superficial, deep, or any wound infections with the intervention.
Conclusions |
Individualized practitioner dashboard distribution may be an effective tool to increase intraoperative glycemic control.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Glycemic and temperature control improves cardiothoracic surgical outcomes. |
• | Individualized practitioner dashboard distribution resulted in a decrease in average and final glucose concentrations during cardiac surgery and an increase in glycemic compliance. There were no effects on the rates of temperature compliance. |
• | Individualized practitioner dashboard distribution may be an effective tool to increase intraoperative glycemic control. |
Keywords : Anesthesia, Cardiac, Cardiac surgery, Hyperglycemia, Hypothermia, Medical informatics, Quality assurance
Plan
Vol 97
Article 111526- octobre 2024 Retour au numéro
Article précédent
- Using Virtual Reality to teach ultrasound-guided needling skills for regional anaesthesia: A randomised controlled trial
- Alwin Chuan, Anton Bogdanovych, Benjamin Moran, Supriya Chowdhury, Yean Chin Lim, Minh T. Tran, Tsz Yui Lee, Jayden Duong, Jennifer Qian, Tung Bui, Alex M.H. Chua, Bahaven Jeyaratnam, Steven Siu, Clement Tiong, Mel McKendrick, Graeme A. McLeod
- Systemic lidocaine versus erector spinae plane block for improving quality of recovery after laparoscopic cholecystectomy: A randomized controlled trial
- Zhiwei Lin, Chanjuan Chen, Shengyuan Xie, Lei Chen, Yusheng Yao, Bin Qian
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?