Complications of coronary artery surgery in diabetic patients.
Postoperative mortality and morbidity of diabetic versus nondiabetic patients undergoing primary coronary artery bypass grafting (CABG) were analyzed. In 1988, 711 patients had CABG procedures, of which 565 were nondiabetic and 146 diabetic. The two groups of patients were statistically similar in regard to age, weight, tobacco and ethanol use, and preoperative levels of cholesterol, triglycerides, blood urea nitrogen (BUN), and creatinine. Preoperative serum glucose levels were significantly elevated in diabetic patients (182 vs. 106, P less than .001). Cardiac output, ejection fraction, and bypass, crossclamp time, and total operating room times were not different for the two groups. Emergent and urgent procedures had a significantly higher mortality rate than elective cases (11.3% and 6.6% vs. 1.7%, respectively; P less than 0.05), but this was independent of the patient's diabetic status. Women had a higher mortality rate than men (6.5% vs. 2.9%; P = 0.05) although within each gender group, there were no differences between diabetics and nondiabetics. There were 27 patients with complications in the diabetic group (18.5%) and 47 in the nondiabetic group (8.3%; P less than .001). The types of complications within the two groups differed in that wound infections (7.5%), postoperative arrhythmias (4.8%), respiratory failure (4.1%), and intra-aortic balloon pump use (4.1%) were significantly greater (P less than .05) in the diabetic patients compared to the nondiabetic (0.9%, 1.8%, 0.4%, and 1.4%, respectively). Occurrences of postoperative pneumothorax, reoperation, myocardial infarction, stroke, urinary tract infection, and pneumonia were similar in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Surgery, William Beaumont Hospital, Royal Oak, Michigan.
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R
Fietsam
J
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Bassett
J L
JL
Glover
D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000401:mortality; D003327:Coronary Disease / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000097:blood; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012307:Risk Factors