Other Titles

Difference in Time of Recognizing Onset in Patients Undergoing Cardiac Surgery with Sternal Wound Infections who have a Hemoglobin A1C below 6.5% and Patients with Sternal Wound Infections who have a Hemoglobin A1C above 6.5% [Poster Title]

Abstract

SWIs remain a critical concern in cardiovascular surgery, contributing to significant morbidity and mortality among patients. The literature review examined multiple studies establishing the relationship between elevated HbA1c levels and increased risk of postoperative complications in relation to glycemic dysregulation and its detrimental effects on wound healing and postoperative infection. Despite existing research exploring the incidence of SWIs and HbA1c levels, a notable gap exists in the literature regarding the time of recognizing SWIs in patients categorized by specific HbA1c benchmarks following cardiac surgery. My research aims to address this gap by evaluating the difference in the time it takes to recognize SWIs in patients with HbA1c levels below 5.7% compared to those with levels above 6.5%. This is particularly significant for nursing practice, as it seeks to inform clinical decision-making and improve early detection strategies for infections in a high-risk population.

The study will be completed via retrospective chart review. The MRNs will be input into an encrypted Excel spreadsheet on an encrypted computer at the University of Virginia School of Nursing or the Claude Moore Health Sciences Library with columns containing the following: patient demographics, surgery date, HbA1c levels, and the date of sternal wound infection incidence following the cardiac-related surgery. Data collection within eligible time frame will be assembled in the spreadsheet. Participants included in the study will be adults ages 18 and older, received cardiac-related surgeries between January 2014 to December 2024, and have recorded HbA1c levels within 12 months before undergoing cardiac-related surgery in their chart. Upon completion, patients will be separated into two groups: patients with HbA1cs below 5.7% and HbA1cs above 6.5%. Statistical analysis will then be conducted via IBM SPSS to correlate dates of surgery with incidence of sternal wound infections between the two groups. Trend analysis with other demographic factors will also be conducted. Following data collection and analysis, a manuscript will be synthesized for publication regarding the findings.

Notes

References:

1. American Diabetes Association (2020). 6. Glycemic Targets: Standards of Medical Care in Diabetes-2020. Diabetes care, 43(Suppl 1), S66-S76.https://doi.org/10.2337/dc20-S006

2. Cheuk, N., Worth, L. J., Tatoulis, J., Skillington, P., Kyi, M., & Fourlanos, S. (2021). The relationship between diabetes and surgical site infection following coronary artery bypass graft surgery in current-era models of care. The Journal of Hospital Infection, 116, 47–52. https://doi.org/10.1016/ j.jhin.2021.07.009

3. Clement, K. C., Suarez-Pierre, A., Sebestyen, K., Alejo, D., DiNatale, J., Whitman, G. J. R., Matthew, T. L., & Lawton, J. S. (2019). Increased Glucose Variability Is Associated With Major Adverse Events After Coronary Artery Bypass. The Annals of Thoracic Surgery, 108(5), 1307–1313.
https://doi.org/10.1016/j.athoracsur.2019.06.046

4. Cooke, B., Williams, L, Delay, T. K., Xie, R., Cornelius, K., Davies, J. E., & Vardas, P. N. (2023). Effect of elevated HbA1c on outcomes in on-pump versus off-pump coronary artery bypass grafting. The Cardiothoracic Surgeon, 31(22). https://doi.org/10.1186/s43057-023-00113-x

5. Joshi, H., Kumara, V., & Bishnoi, A. K. (2020). Study on association of preoperative glycosylated haemoglobin level and outcome after cardiac surgery. Sri Lankan Journal of Anaesthesiology, 28(1): 14-18. https://doi.org/10.4038/slja.v28i1.8467

Description

The global prevalence of cardiovascular diseases rises each year alongside the demand for cardiac surgeries. This study evaluates the difference in time to recognize SWIs in patients with HbA1c levels below 5.7% and above 6.5%. By recognizing the nuances of glycemic control in relation to postoperative outcomes, the findings from this study can contribute to developing personalized patient interventions, enhancing patient recovery, and ultimately reduce surgical complications.

Author Details

Marisa Tran Le, BSN; Sarah Craig, PhD, RN, CCNS, CCRN-K, CNE, CHSE

Sigma Membership

Beta Kappa

Type

Poster

Format Type

Text-based Document

Study Design/Type

Literature Review

Research Approach

Other

Keywords:

Acute Care, Implementation Science, Competence, Sternal Wound Infections, Cardiovascular Surgery, Postoperative Complications, HbA1c Levels

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Click on the above link to access the poster.

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Hemoglobin A1C and Timing of Sternal Wound Infection Recognition in Cardiac Surgery

Seattle, Washington, USA

SWIs remain a critical concern in cardiovascular surgery, contributing to significant morbidity and mortality among patients. The literature review examined multiple studies establishing the relationship between elevated HbA1c levels and increased risk of postoperative complications in relation to glycemic dysregulation and its detrimental effects on wound healing and postoperative infection. Despite existing research exploring the incidence of SWIs and HbA1c levels, a notable gap exists in the literature regarding the time of recognizing SWIs in patients categorized by specific HbA1c benchmarks following cardiac surgery. My research aims to address this gap by evaluating the difference in the time it takes to recognize SWIs in patients with HbA1c levels below 5.7% compared to those with levels above 6.5%. This is particularly significant for nursing practice, as it seeks to inform clinical decision-making and improve early detection strategies for infections in a high-risk population.

The study will be completed via retrospective chart review. The MRNs will be input into an encrypted Excel spreadsheet on an encrypted computer at the University of Virginia School of Nursing or the Claude Moore Health Sciences Library with columns containing the following: patient demographics, surgery date, HbA1c levels, and the date of sternal wound infection incidence following the cardiac-related surgery. Data collection within eligible time frame will be assembled in the spreadsheet. Participants included in the study will be adults ages 18 and older, received cardiac-related surgeries between January 2014 to December 2024, and have recorded HbA1c levels within 12 months before undergoing cardiac-related surgery in their chart. Upon completion, patients will be separated into two groups: patients with HbA1cs below 5.7% and HbA1cs above 6.5%. Statistical analysis will then be conducted via IBM SPSS to correlate dates of surgery with incidence of sternal wound infections between the two groups. Trend analysis with other demographic factors will also be conducted. Following data collection and analysis, a manuscript will be synthesized for publication regarding the findings.