Early postoperative outcome and medium-term survival in 540 diabetic and 2239 nondiabetic patients undergoing coronary artery bypass grafting.
BACKGROUND
An increasing proportion of patients undergoing coronary artery bypass grafting (CABG) are diabetics. Patient characteristics, early postoperative outcome, and midterm survival in diabetic patients after CABG were investigated.


METHODS
A total of 2779 consecutive patients undergoing isolated CABG during 1995 to 1999 were studied, 19.4% of whom had diabetes mellitus. Demographic and peri-procedural data were registered prospectively in a computerized institutional database.


RESULTS
The diabetic group was younger and included a higher proportion of women, and patients with hypertension, triple-vessel disease, and unstable angina. They required a higher number of bypasses, and longer cross-clamp and cardiopulmonary bypass times. Intensive care unit and hospital stays were prolonged and the need for inotropic agents, hemotransfusions, and dialysis was higher in the diabetic group. Renal failure, stroke (4.3% versus 1.7%), mediastinitis, and wound infections were more frequently encountered. Thirty-day mortality was 2.6% versus 1.6% (p = 0.15). Cumulative 5-year survival was 84.4% versus 91.3% (p < 0.001).


CONCLUSIONS
Short-term mortality was acceptable in diabetic patients after CABG but they had increased postoperative morbidity in comparison with nondiabetic patients, particularly with regard to renal function, cerebral complications, and infections. Midterm survival was impaired in diabetic patients mainly because of a less favorable outcome in patients treated with insulin.
Szabó
Zoltán
Z
Håkanson
Erik
E
Svedjeholm
Rolf
R
D000368:Aged; D002423:Cause of Death; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000601:surgery*; D003922:Diabetes Mellitus, Type 1 / Q000401:mortality / Q000601:surgery*; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality / Q000601:surgery*; D003925:Diabetic Angiopathies / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D012307:Risk Factors; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology