Infectious Diseases Society of America (IDSA)’nın düzenlediği IDWeek 2015™’te sunulan bir postere göre, karaciğer nakli alıcılarında kandaki glukozun doğru şekilde yönetilmesi nakil sonrası cerrahi alan infeksiyonları insidansını azaltmadı.

Glucose management did not reduce SSI incidence post-liver transplant

October 14, 2015

SAN DIEGO — Data presented during a poster session at IDWeek 2015 showed that proper management of blood glucose among liver transplant recipients did not reduce the risk for developing surgical site infection post-transplant.

After a randomized clinical trial comparing intensive glucose management (IGM) and conventional glucose management (CGM) following liver transplantation (LT) failed to demonstrate a reduction in 90-day composite outcome of infection, rejection or re-hospitalization, researchers conducted a substudy to assess the effect of IGM on the incidence of surgical site infection (SSI) after LT.

In the substudy, 197 recipients received either IGM (n = 97) or CGM (n = 100) during a hospital stay following LT. The target blood glucose was between 90 and 120 mg/dL for patients undergoing IGM and target blood glucose between 120 and150 mg/dL in the intensive care unit and 140 to 180 mg/dL on the floor among the patients who underwent CGM, according to the abstract.

The occurrence of SSI within 30 days of LT was measured using a retrospective chart review with definitions of the National Healthcare Safety Network. Unadjusted Cox proportional hazards regression models were also used to compare the risk for SSI between the two groups of patients.

Overall, 15.5% of patients in the IGM group (n = 15) developed SSI compared with 9% in the CGM group (n = 9). However, this difference was not significant (relative ratio [RR] = 1.74; 95% CI, 0.77-4.13). The mean blood glucose during the hospital stay after LT was 134 mg/dL among patients in the IGM group compared with 158 mg/dL among patients in the CGM group (P < .001).

When the researchers evaluated organ/space SSI as a secondary outcome, they did not observe a significant difference between the IGM group and CGM group (7.2% vs. 6%; RR = 1.19; 95% CI, 0.40-3.69; P = .75). No patient developed a deep incisional SSI, according to the researchers.

The researchers concluded: “Postoperative intensive glucose management during the transplant hospitalization does not reduce the incidence of SSI after LT.”

Reference:

Steele HP, et al. Abstract 369. Presented at: IDWeek; Oct. 7-11, 2015; San Diego.

Disclosures: Healio.com/Hepatology was unable to confirm relevant financial disclosures at the time of publication.