The influence of diabetes mellitus in patients undergoing coronary artery bypass graft surgery: a prospective cohort study.
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.
Woods
Scott E
SE
Bethesda Family Medicine Residency Program, Cincinnati, Ohio 45212, USA. liverdoctor@yahoo.com
Eppley
Chris
C
Engel
Amy
A
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
D007004:Hypoglycemic Agents; D007328:Insulin