Glycemic Control Clinical Trial
Official title:
A Quality Initiative to Improve Glycemic Control in Diabetic and Non-Diabetic Patients After Vascular Surgery
The aim of this study is to examine the effect of moderate glucose (blood sugar) control in diabetic and non-diabetic patients undergoing leg bypass surgery (LEB) or open abdominal aortic aneurysm (AAA) repair. We hypothesize that use of Fletcher Allen Health Care's current insulin infusion strategy will result in improved blood sugar control which will translate into decreased postoperative morbidity (fewer complications) and better long term outcomes when compared to patient outcomes at other institutions which utilize other blood sugar management strategies.
Status | Completed |
Enrollment | 89 |
Est. completion date | June 2016 |
Est. primary completion date | June 2016 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years to 99 Years |
Eligibility |
Inclusion Criteria: - Consecutive patients, all patients on the vascular service undergoing elective open AAA repair or infrainguinal LEB for claudication or critical limb ischemia will be approached and given the choice to participate in or to decline the study. Diabetic and non-diabetic. Exclusion Criteria: - Patients with purely acute limb ischemia will be excluded. Emergency operations including ruptured AAA repairs will be excluded. Also patients on a preoperative insulin infusion will be excluded. |
Observational Model: Cohort, Time Perspective: Prospective
Country | Name | City | State |
---|---|---|---|
United States | Fletcher Allen Health Care | Burlington | Vermont |
Lead Sponsor | Collaborator |
---|---|
University of Vermont Medical Center |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | glycemic control | 1. Glycemic control as measured by mean daily glucose levels and mean daily glucose excursions. We will look at the patients' finger-stick records and record the time spent at goal glucose levels, 80 to 150 mg/dL. | during intial hospital stay which is an average of 3 to 7 days | No |
Primary | surgical site infection | Surgical site infection (SSI) in-hospital will be defined according to the Centers for Disease Control definition16 as an infection that occurs within 30 days after the operative procedure and involves only skin and subcutaneous tissue of the infection and includes one of the following: purulent drainage from superficial incision organisms isolated from an aseptically obtained culture of fluid or tissue from the superficial incision at least one of the following signs or symptoms of infection: pain or tenderness, localized swelling, redness, or heat and the incision is deliberately opened by the surgeon, and is culture positive or not cultured. Culture negative does not meet this criterion. Diagnosis of superficial incisional SSI by the surgeon or attending. |
30 days | No |
Secondary | hypo and hyper glycemic events | . Moderate to severe hypoglycemic or hyperglycemic events as defined by moderate hypoglycemic event as <66 mg/dl and severe hypoglycemic event as <50 mg/dl and moderate hyperglycemic event as >250 mg/dl and severe hyperglycemic event as >500 mg/dl. | during initial hospital stay avg 3 to 7 days | No |
Secondary | cardiac complications | Composite cardiac complications: myocardial infarction, congestive heart failure and clinically significant arrhythmias within 30 days of surgery | 30 days | No |
Secondary | length of stay | Hospital length of stay | initial hospitalization avg 3 to 7 days | No |
Secondary | re-admission | At the patient's 4 week follow-up they will be asked if since their discharge have they had any health related visits; if so what type and for anything possibly related to surgical procedure; will obtain participant's permission (in writing) to gather data from other provider. | at 4 week follow-up | No |
Secondary | Costs | Cost data will be obtained through Fletcher Allen administrative data. | 30 days | No |
Status | Clinical Trial | Phase | |
---|---|---|---|
Completed |
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