Coronary artery bypass surgery in diabetic patients.
BACKGROUND
Cardiovascular disease is a major cause of morbidity and mortality in patients with diabetes. This study examines the impact of diabetes on mortality and morbidity following coronary artery bypass surgery.


METHODS
We retrospectively analyzed 590 consecutive patients after coronary artery bypass grafting in 1998. Reoperations and combined procedures were excluded. A total of 137 diabetic (23.2%) and 453 nondiabetic patients were evaluated. Among the diabetics, 53 were treated with insulin and 84 were non-insulin-dependent. Diabetics suffered more frequently from hypertension, peripheral vascular disease, and more often had an increased body mass index (BMI).


RESULTS
There was no significant difference in mortality and major complications among insulin-dependent diabetics, non-insulin-dependent diabetics, and nondiabetic patients. Diabetics suffered more often from superficial sternal wound infection and had a higher incidence of superficial wound infections at the vein harvest site.


CONCLUSIONS
The present study suggests that diabetes increases the risk of superficial wound infections after coronary artery bypass grafting. But diabetics do not necessarily have an increased risk of major complications and mortality.
Brandt
Michael
M
Department of Cardiovascular Surgery, University Hospital Kiel, Kiel, Germany. mbrandt@kielheart.uni-kiel.de
Harder
Kristina
K
Walluscheck
Knut P
KP
Fraund
Sandra
S
Böning
Andreas
A
Cremer
Jochen
J
D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D016022:Case-Control Studies; D015897:Comorbidity; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods* / Q000401:mortality; D003327:Coronary Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology; D003925:Diabetic Angiopathies / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications / Q000401:mortality; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis; D016896:Treatment Outcome