title: The influence of diabetes mellitus in patients undergoing coronary artery bypass graft surgery: a prospective cohort study.
abstract: This study was conducted to prospectively assess if there are any outcome differences between patients undergoing coronary artery bypass graft surgery with and without diabetes. This is an 11-year, prospective, hospitalization cohort study. Data were collected on 225 variables. A total of 8935 patients were available for our analysis (6023 nondiabetics, 319 diet-controlled diabetics, 1636 diabetics on oral medications, 957 insulin-controlled diabetics). Compared with nondiabetics, diet-treated diabetics possessed four significant comorbidities, diabetics treated with oral medications possessed 12 significant comorbidities, and insulin-treated diabetics possessed 13 significant comorbidities (P < 0.05). There was no significant difference between diet-treated diabetics and nondiabetics for all outcomes. Diabetics treated with oral medications possessed a longer length of stay [relative risk (RR), 1.09; CI, 1.08-1.10], longer intensive care unit length of stay (RR, 1.56; CI, 1.12-2.00), and more intraoperative complications (RR, 1.42; CI, 1.12-1.66). Insulin-treated diabetics possessed more neurological complications (RR, 2.39; CI, 1.52-3.77), wound complications (RR, 2.42; CI, 1.19-4.95), and renal complications (RR, 2.43; CI, 1.70-3.49), longer length of stay (RR, 1.20; CI, 1.14-1.27), and longer intensive care unit length of stay (RR, 1.33; CI, 1.16-1.48). In diabetics undergoing coronary artery bypass graft surgery, as their diabetes progresses from diet treated with oral medications to insulin-dependent, this is associated with more comorbidities at surgical presentation and more morbidity after surgery.
authors.affiliation: Bethesda Family Medicine Residency Program, Cincinnati, Ohio 45212, USA. liverdoctor@yahoo.com
authors.forename: Scott E
authors.initials: SE
authors.lastname: Woods
authors.forename: Chris
authors.initials: C
authors.lastname: Eppley
authors.forename: Amy
authors.initials: A
authors.lastname: Engel
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications* / Q000601:surgery*; D048909:Diabetes Complications / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D003927:Diet, Diabetic; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin