Clinical Study

Successful Implementation of a Perioperative Glycemic Control Protocol in Cardiac Surgery: Barrier Analysis and Intervention Using Lean Six Sigma

Table 2

Retrospective evaluation of glucose data by project phase.

BaselinePhase 1Phase 2Phase 3Phase 4Phase 5FinalP value

Patientsn390221267221204279310
Glucose datapointsn377825051106313255135091818019043
Datapoints/ patient/dayMean (±SD)3 (±2)3 (±2)8 (±3)12 (±5)11 (±5)11 (±5)12 (±4)<0.001a
Admit glucose (mg/dL)Median (IQR)160 (67)144 (56)161 (57)144 (58)136 (57)133 (49)124 (48)<0.001b
Admit glucose <200 mg/dL% (n)76 (297)89 (197)81 (217)87 (192)90 (184)95 (266)94 (291)<0.001c
TWGL (mg/dL)Mean (±SD)141 (±26)133 (±27)129 (±22)116 (±12)112 (±11)111 (±11)111 (±11)<0.001a
Median (IQR)138 (32)129 (37)129 (20)115 (15)110 (11)109 (14)109 (13)<0.001b
Time to glucose control (hr)Median (IQR)16 (22)15 (17)12 (11)11 (10)9 (9)10 (8)9 (8)<0.001b
Glucose 6 h control% (n)0 (0)0.5 (1)7.1 (19)4.5 (10)5.9 (12)8.6 (24)11 (34)<0.001c
Hypoglycemia events% (n)1.7 (63)1.5 (38)1.5 (168)1.2 (161)0.7 (90)0.9 (160)0.9(173)<0.001c
Hypoglycemic patients%(n)9.5 (37)10.9 (24)21.3 (57)23.1 (51)21.6 (44) 16.8 (47)19 (59)<0.001c

aOne-way ANOVA; bKruskalWallis ANOVA; cChisquare.
IQR: Interquartile range; Max: maximum; 𝑛 : number of patients; SD: standard deviation; TWGL: timeweighted glucose levels.