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Rutgers University

1. Al Zayer, Ali A., 1984-. Evaluation of nosocomial infection rates in ‎diabetic patients undergoing coronary artery ‎bypass grafting (CABG) surgery.

Degree: PhD, Biomedical Informatics, 2017, Rutgers University

URL: https://rucore.libraries.rutgers.edu/rutgers-lib/52939/ 

BACKGROUND: There is a conflict evidence about the association of using ‎bilateral internal mammary ‎artery (BIMA) grafting in diabetics undergoing coronary ‎artery bypass grafting (CABG) ‎surgery and increased risk of contracting surgical site ‎infection. The direct impact of the ‎diabetics glycemic control status and using the ‎optimal grafting method on surgical ‎site infection is still not conclusive in literature. ‎The aim of the study is to evaluate the ‎impact of Bilateral internal mammary artery ‎grafting in diabetic patients, the diagnosis ‎of diabetes mellitus, and its glycemic control ‎status on different kinds of nosocomial ‎infections. The assumption was made that those ‎exposures associated with higher risk of ‎surgical site infection, urinary tract infection, ‎blood stream infection and pneumonia. METHOD: A retrospective cohort is conducted ‎by utilizing Nationwide Inpatient ‎Sample (NIS) data from the Agency of Healthcare ‎Research and Quality (AHRQ). All ‎patients who were admitted to coronary artery ‎bypass grafting (CABG) surgery were ‎retrieved from 2007 to 2012 and grouped based on ‎the exposures of the study. RESULTS: The total sample of the study was 286,487 ‎patients underwent CABG ‎surgery. There were 122,642 (42.81%) patients diagnosed ‎with Diabetes Mellitus, of ‎whom 18,065 (14.73%) had uncontrolled hyperglycemia, ‎‎3,700 (3.01%) received ‎Bilateral (IMA) and 103,577 (84.45%) unilateral or single (IMA) ‎grafting method. The ‎study population was predominantly white (79.78%) and male ‎‎(72.08%) with an average ‎age of 66 (SD ±10.89) old. About 215,740 (75.31%) of ‎patients had developed ‎nosocomial pneumonia, 16,667 (5.82%) urinary tract infections ‎‎(UTIs), 9,442 (3.3%) ‎sepsis or bloodstream infection (BSIs), and 5,302 (1.85%) surgical ‎site infection (SSIs ‎in overall sample population.‎Among diabetic patients, there was no significant difference in comparing ‎BIMA ‎versus SIMA for surgical site infection (SSI) (p-value=0.2491) and blood ‎stream ‎infections (BSI) (p-value=0.6630). The results have also indicated that UTIs ‎‎(4.2% vs. ‎‎5.5%; p-value=0.0005) was significantly lower with BIMA grafting method. ‎However, ‎results did not meet the hypothesis assumption regarding Pneumonias rate ‎‎(76.8% vs. ‎‎70.5%; p-value < 0.0001) and was significantly higher with BIMA compared ‎to SIMA ‎grafting method. Multivariable analysis showed inconsistent result and ‎confirmed that ‎BIMA grafting predicts higher odd of BSI by 44.6% in diabetic, ‎compared to SIMA ‎grafting (OR: 1.446; 95% CI: 1.22-1.71; p<.0001). ‎The cross unadjusted baseline results for all nosocomial infections ‎were ‎significantly lower in diabetic patients compared to non-diabetic; Except for UTI ‎was ‎significantly higher by the presence of diabetes in BIMA grafting population ‎‎(n=10,223) ‎‎(4.2% vs. 3.39%; p-value= 0.0393). Multivariable analysis has confirmed ‎that Diabetes ‎Miletus increase the risk of UTI by 21.7% in BIMA population (OR: ‎‎1.217; 95% CI: 1.21-‎‎1.22; p<.0001). ‎The bivariate analysis results indicated… Advisors/Committee Members: Srinivasan, Shankar (chair), School of Health Professions.

Subjects/Keywords: Cross infection; Coronary artery bypass; Diabetics – Surgery

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Al Zayer, Ali A., 1. (2017). Evaluation of nosocomial infection rates in ‎diabetic patients undergoing coronary artery ‎bypass grafting (CABG) surgery. (Doctoral Dissertation). Rutgers University. Retrieved from https://rucore.libraries.rutgers.edu/rutgers-lib/52939/

Chicago Manual of Style (16th Edition):

Al Zayer, Ali A., 1984-. “Evaluation of nosocomial infection rates in ‎diabetic patients undergoing coronary artery ‎bypass grafting (CABG) surgery.” 2017. Doctoral Dissertation, Rutgers University. Accessed December 09, 2019. https://rucore.libraries.rutgers.edu/rutgers-lib/52939/.

MLA Handbook (7th Edition):

Al Zayer, Ali A., 1984-. “Evaluation of nosocomial infection rates in ‎diabetic patients undergoing coronary artery ‎bypass grafting (CABG) surgery.” 2017. Web. 09 Dec 2019.

Vancouver:

Al Zayer, Ali A. 1. Evaluation of nosocomial infection rates in ‎diabetic patients undergoing coronary artery ‎bypass grafting (CABG) surgery. [Internet] [Doctoral dissertation]. Rutgers University; 2017. [cited 2019 Dec 09]. Available from: https://rucore.libraries.rutgers.edu/rutgers-lib/52939/.

Council of Science Editors:

Al Zayer, Ali A. 1. Evaluation of nosocomial infection rates in ‎diabetic patients undergoing coronary artery ‎bypass grafting (CABG) surgery. [Doctoral Dissertation]. Rutgers University; 2017. Available from: https://rucore.libraries.rutgers.edu/rutgers-lib/52939/

2. ΑΧΙΛΛΕΩΣ, ΚΩΝΣΤΑΝΤΙΑ. Η ΚΑΘΑΡΣΗ (CLEARANCE) ΤΗΣ ΚΡΕΑΤΙΝΙΝΗΣ ΣΕ ΥΠΕΡΤΑΣΙΚΟΥΣ ΚΑΙ ΔΙΑΒΗΤΙΚΟΥΣ ΑΣΘΕΝΕΙΣ ΠΡΟΕΓΧΕΙΡΗΤΙΚΑ ΚΑΙ ΜΕΤΕΓΧΕΙΡΗΤΙΚΑ.

Degree: 1995, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών (ΕΚΠΑ); National and Kapodistrian University of Athens

URL: http://hdl.handle.net/10442/hedi/5307 

ΔΙΑΠΙΣΤΩΣΗ ΑΡΝΗΤΙΚΗΣ ΕΠΙΔΡΑΣΗΣ ΤΗΣ ΧΕΙΡΟΥΡΓΙΚΗΣ ΕΠΕΜΒΑΣΗΣ ΣΤΗΝ ΝΕΦΡΙΚΗ ΛΕΙΤΟΥΡΓΙΑ. ΜΕΤΕΓΧΕΙΡΗΤΙΚΗ ΑΥΞΗΣΗ ΤΗΣ ΤΙΜΗΣ ΤΗΣ ΚΡΕΑΤΙΝΙΝΗΣ ΟΡΟΥ ΣΤΑΤΙΣΤΙΚΑ ΣΗΜΑΝΤΙΚΗ ΣΤΟΥΣ ΜΑΡΤΥΡΕΣ, ΥΠΕΡΤΑΣΙΚΟΥΣ ΚΑΙ ΔΙΑΒΗΤΙΚΟΥΣ. ΜΕΤΕΓΧΕΙΡΗΤΙΚΗ ΑΥΞΗΣΗ ΤΗΣ ΚΑΘΑΡΣΗΣ ΤΗΣ ΚΡΕΑΤΙΝΙΝΗΣ ΣΤΟΥΣ ΜΑΡΤΥΡΕΣ ΚΑΙ ΜΕΙΩΣΗ ΣΤΟΥΣ ΔΙΑΒΗΤΙΚΟΥΣ ΚΑΙ ΥΠΕΡΤΑΣΙΚΟΥΣ. ΣΤΑΤΙΣΤΙΚΑ ΣΗΜΑΝΤΙΚΗ Η ΕΠΩΑΣΗ ΣΤΟΥΣ ΥΠΕΡΤΑΣΙΚΟΥΣ ΜΟΝΟ. ΣΥΜΠΕΡΑΣΜΑΤΙΚΑ Η ΧΕΙΡΟΥΡΓΙΚΗ ΕΠΕΜΒΑΣΗ Η/ΚΑΙ Η ΑΝΑΙΣΘΗΣΙΑ ΕΠΙΔΡΟΥΝ ΑΡΝΗΤΙΚΑ ΣΤΗ ΝΕΦΡΙΚΗ ΛΕΙΤΟΥΡΓΙΑ. ΣΤΟΥΣ ΑΣΘΕΝΕΙΣ ΜΕ ΦΥΣΙΟΛΟΓΙΚΗ ΠΡΙΝ ΑΠΟ ΤΗΝ ΕΠΕΜΒΑΣΗ ΝΕΦΡΙΚΗ ΛΕΙΤΟΥΡΓΙΑ ΔΕΝ ΣΥΝΙΣΤΑ ΑΜΕΣΟ ΚΙΝΔΥΝΟ ΑΝΑΠΤΥΞΗΣ ΟΞΕΙΑΣ ΝΕΦΡΙΚΗΣ ΑΝΕΠΑΡΚΕΙΑΣ. ΣΤΑ ΑΤΟΜΑ ΜΕ ΝΟΣΗΜΑ ΤΟΥ ΟΥΡΟΠΟΙΗΤΙΚΟΥ Η ΕΠΙΔΡΑΣΗ ΤΗΣ ΕΠΕΜΒΑΣΗΣ Η/ΚΑΙ ΤΗΣ ΑΝΑΙΣΘΗΣΙΑΣ ΣΤΗ ΝΕΦΡΙΚΗ ΛΕΙΤΟΥΡΓΙΑ ΕΙΝΑΙ ΠΕΡΙΣΣΟΤΕΡΟ ΕΚΔΗΛΗ. ΣΤΑ ΑΤΟΜΑ ΜΕ ΝΟΣΟ ΠΟΥ ΠΑΡΟΥΣΙΑΖΕΙ ΕΠΙΠΛΟΚΕΣ ΑΠΟ ΤΟ ΟΥΡΟΠΟΙΗΤΙΚΟ Η ΕΠΙΔΡΑΣΗ ΤΗΣ ΕΠΕΜΒΑΣΗΣ Η/ΚΑΙ ΤΗΣ ΑΝΑΙΣΘΗΣΙΑΣ ΣΤΗ ΝΕΦΡΙΚΗ ΛΕΙΤΟΥΡΓΙΑ ΕΙΝΑΙ ΠΕΡΙΣΣΟΤΕΡΟ ΕΚΔΗΛΗ.

CONFIRMATION OF THE NEGATIVE EFFECT OF SURGERY ON THE RENAL FUNCTION. POSTOPERATIVELY INCREASE OF SERUM CREATININE STATISTICALLY SIGNIFICANT IN THE CONTROL GROUP, IN THE HYPERTENSIVES GROUP AND IN THE DIABETICS GROUP. POSTOPERATIVELY INCREASE OF CREATININE CLEARANCE IN THE CONTROL GROUP AND DECREASE IN THE HYPERTENSIVES GROUP AND IN THE DIABETES GROUP. STATISTICALLY SIGNIFICANT THE DECREASE IN THE HYPERTENSIVES ONLY. IN CONCLUSION SURGERY AND/OR ANESTHESIA HAVE A NEGATIVE EFFECT ON RENAL FUNCTION, BUT THIS FACT DOES NOT INVOLVE DIRECT DANGEROF ACUTE RENAL FAILURE FOR PATIENTS WITH NORMAL, PREOPERATIVELY, KIDNEYS. THETEMPORARY DECREASE OF RENAL FUNCTION MUST BE SERIOUSLY CONSIDERED IN PATIENTSWITH URINARY DISEASE OR ILLNESS RESULTING IN URINARY COMPLICATIONS, AS IN SUCH CASES THE EFFECT OF SURGERY AND/OR ANESTHESIA BECOMES MORE PROMINENT.

Subjects/Keywords: Anesthesia; Diabetics; HYPERTENSIVES; Renal function; Surgery; Αναισθησία; Διαβητικοί; Νεφρική λειτουργία; ΥΠΕΡΤΑΣΙΚΟΙ; Χειρουργική επέμβαση

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

ΑΧΙΛΛΕΩΣ, . (1995). Η ΚΑΘΑΡΣΗ (CLEARANCE) ΤΗΣ ΚΡΕΑΤΙΝΙΝΗΣ ΣΕ ΥΠΕΡΤΑΣΙΚΟΥΣ ΚΑΙ ΔΙΑΒΗΤΙΚΟΥΣ ΑΣΘΕΝΕΙΣ ΠΡΟΕΓΧΕΙΡΗΤΙΚΑ ΚΑΙ ΜΕΤΕΓΧΕΙΡΗΤΙΚΑ. (Thesis). Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών (ΕΚΠΑ); National and Kapodistrian University of Athens. Retrieved from http://hdl.handle.net/10442/hedi/5307

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

ΑΧΙΛΛΕΩΣ, ΚΩΝΣΤΑΝΤΙΑ. “Η ΚΑΘΑΡΣΗ (CLEARANCE) ΤΗΣ ΚΡΕΑΤΙΝΙΝΗΣ ΣΕ ΥΠΕΡΤΑΣΙΚΟΥΣ ΚΑΙ ΔΙΑΒΗΤΙΚΟΥΣ ΑΣΘΕΝΕΙΣ ΠΡΟΕΓΧΕΙΡΗΤΙΚΑ ΚΑΙ ΜΕΤΕΓΧΕΙΡΗΤΙΚΑ.” 1995. Thesis, Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών (ΕΚΠΑ); National and Kapodistrian University of Athens. Accessed December 09, 2019. http://hdl.handle.net/10442/hedi/5307.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

ΑΧΙΛΛΕΩΣ, ΚΩΝΣΤΑΝΤΙΑ. “Η ΚΑΘΑΡΣΗ (CLEARANCE) ΤΗΣ ΚΡΕΑΤΙΝΙΝΗΣ ΣΕ ΥΠΕΡΤΑΣΙΚΟΥΣ ΚΑΙ ΔΙΑΒΗΤΙΚΟΥΣ ΑΣΘΕΝΕΙΣ ΠΡΟΕΓΧΕΙΡΗΤΙΚΑ ΚΑΙ ΜΕΤΕΓΧΕΙΡΗΤΙΚΑ.” 1995. Web. 09 Dec 2019.

Vancouver:

ΑΧΙΛΛΕΩΣ . Η ΚΑΘΑΡΣΗ (CLEARANCE) ΤΗΣ ΚΡΕΑΤΙΝΙΝΗΣ ΣΕ ΥΠΕΡΤΑΣΙΚΟΥΣ ΚΑΙ ΔΙΑΒΗΤΙΚΟΥΣ ΑΣΘΕΝΕΙΣ ΠΡΟΕΓΧΕΙΡΗΤΙΚΑ ΚΑΙ ΜΕΤΕΓΧΕΙΡΗΤΙΚΑ. [Internet] [Thesis]. Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών (ΕΚΠΑ); National and Kapodistrian University of Athens; 1995. [cited 2019 Dec 09]. Available from: http://hdl.handle.net/10442/hedi/5307.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

ΑΧΙΛΛΕΩΣ . Η ΚΑΘΑΡΣΗ (CLEARANCE) ΤΗΣ ΚΡΕΑΤΙΝΙΝΗΣ ΣΕ ΥΠΕΡΤΑΣΙΚΟΥΣ ΚΑΙ ΔΙΑΒΗΤΙΚΟΥΣ ΑΣΘΕΝΕΙΣ ΠΡΟΕΓΧΕΙΡΗΤΙΚΑ ΚΑΙ ΜΕΤΕΓΧΕΙΡΗΤΙΚΑ. [Thesis]. Εθνικό και Καποδιστριακό Πανεπιστήμιο Αθηνών (ΕΚΠΑ); National and Kapodistrian University of Athens; 1995. Available from: http://hdl.handle.net/10442/hedi/5307

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

.