• Vikaesh Moorthy, Ming Ann Sim, Weiling Liu, TiLian KahLKNational University Hospital, Department of Anaesthesia, Singapore., and ChewSophia Tsong HueySTHSingapore General Hospital, Department of Anaesthesia, Singapore. Electronic address: rnsctlk@gmail.com..
• National University of Singapore, Yong Loo Lin School of Medicine, Singapore.
• J. Cardiothorac. Vasc. Anesth. 2019 Feb 1; 33 (2): 388-393.

ObjectivePostoperative hyperglycemia is a known risk factor for adverse outcomes following cardiac surgery. Therefore, the authors investigated the association between ethnicity and postoperative hyperglycemia in a Southeast Asian multiethnic population undergoing cardiac surgery.DesignPerioperative data were analyzed prospectively.SettingPerioperative data were obtained from 2008 to 2010 at the 2 main heart centers in Singapore.ParticipantsData from 911 adult patients were collected.InterventionsAll patients underwent elective cardiac surgery.Measurements And Main ResultsPerioperative variables, genetic associations, and outcomes of hyperglycemic versus normoglycemic patients were compared. Of the 911 patients analyzed, 47.7% (n = 435) were diabetic and 77.7% (n = 708) had postoperative hyperglycemia. Patients with postoperative hyperglycemia after cardiac surgery were more likely to have diabetes; be female, older, and more obese; and have hypertension and renal impairment. Patients of Indian ethnicity had a significantly higher incidence of postoperative hyperglycemia (86.7%, p = 0.043), as compared to Malays (79.1%) and Chinese (75.9%). Ethnicity was identified as an independent risk factor for postoperative hyperglycemia, with Indians having a significantly higher risk than Chinese (OR 2.115, p = 0.015). Although Indian ethnicity was associated with the presence of angiotensin-converting enzyme D allele (65.7%, p = 0.044), no genetic associations with postoperative hyperglycemia were identified. Postoperative hyperglycemia also was associated significantly with poorer outcomes of longer high-dependency unit stay and new-onset cardiac arrhythmias.ConclusionThe authors' findings demonstrated Indian ethnicity as an independent risk factor of postoperative hyperglycemia, likely due to insulin resistance and exaggerated hyperglycemic stress response, emphasizing the need for ethnic-based data unique to each population group.Copyright © 2018 Elsevier Inc. All rights reserved.

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