Comparison of the frequency of post-operative wound infection and mean length of ICU stay after tight versus standard glycemic control among diabetic patients undergoing CABG.

Abstract

Objective: To compare post-operative wound infection rates and average ICU stay length in diabetic patients undergoing coronary artery bypass surgery at Azra Naheed Medical College, Lahore, based on strict glycemic control versus standard glycemic control. Study Design: Randomized Controlled Trial. Setting: Azra Naheed Medical College, Lahore. Period: January 2023 to June 2023. Methods: Total 260 eligible diabetic patients scheduled for surgery provided informed consent following ethical committee approval. A lottery-based randomization process allocated patients to Group A (tight glycemic control, blood sugar levels 120-160 mg/dL) or Group B (standard glycemic control, blood sugar levels 161-200 mg/dL). Treatment was as per standard protocols, and blood sugar levels were monitored accordingly. Proforma entries documented ICU stay and wound infections during hospitalization, ensuring data confidentiality. Results: The study involved 260 cases, with 130 in each group. In Group-B, the mean age was 51.56+6.07 years, and in Group-A, it was 52.09+5.86 years. Males constituted 53.85% (n=70) in Group-B and 53.08% (n=69) in Group-A, while females were 46.15% (n=60) in Group-A and 46.92% (n=61). Wound infection development differed, with 29.23% (n=38) in Group-A and 59.23% (n=77) in Group-B. The remaining 70.77% (n=92) in Group-A remained infection-free. Regarding mean hospital stays, Group-A stayed for 3.92+0.95 days, while Group-B spent 5.73+0.76 days (p = 0.0001). Conclusion: Strict glycemic control significantly reduces postoperative infections and ICU stay duration in diabetic patients undergoing coronary artery bypass surgery compared to standard glycemic control.