title: Impact of diabetes mellitus on outcomes in Japanese patients undergoing coronary artery bypass grafting.
abstract: OBJECTIVE
  There have been no large-scale studies on the impact of diabetes mellitus (DM) on outcomes in Japanese patients undergoing coronary artery bypass grafting (CABG).
  
  
  METHODS
  A multi-institutional retrospective cohort study was conducted in 14 Japanese centers. All adult patients who underwent isolated CABG from 2007 to 2008 were included (n=1522, mean age: 68.5years). The definitions of DM were all patients admitted with diagnosis of DM and preoperative glycated hemoglobin (Hb) A1c≥6.5%. Univariate and multivariate analyses were performed to identify the risk of morbidity and mortality.
  
  
  RESULTS
  There were 849 DM and 572 non-DM patients. Preoperative mean HbA1c were 7.1% in the DM group and 5.7% in the non-DM group (p<0.0001). Preoperative, intraoperative, and 3-day average postoperative blood glucose (BG) were 146mg/dl, 172mg/dl, and 168mg/dl in the DM group, and 103mg/dl, 140mg/dl, and 136mg/dl in the non-DM group (all p<0.0001). Although there were no significant differences in postoperative cardiovascular events, the incidence of infection was significantly higher in the DM group than in the non-DM group (9.2% vs 6.1%, p=0.036) on the univariate analysis. The all-cause death was also relatively higher in the DM group than in the non-DM group (2.1% vs 1.1%, p=0.12), and this was likely related to infection.
  
  
  CONCLUSIONS
  DM patients had worse perioperative BG control, higher incidence of infection, and higher mortality than non-DM patients. These results indicate that perioperative BG control guidelines should be standardized to obtain better surgical outcomes in Japanese DM patients.
authors.affiliation: Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Minakata
authors.forename: Ko
authors.initials: K
authors.lastname: Bando
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Takanashi
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Konishi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Miyamoto
authors.forename: Kenji
authors.initials: K
authors.lastname: Ueshima
authors.forename: Tosiya
authors.initials: T
authors.lastname: Sato
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ueda
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Okita
authors.forename: Izuru
authors.initials: I
authors.lastname: Masuda
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Okabayashi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yaku
authors.forename: Shinji
authors.initials: S
authors.lastname: Yasuno
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Muranaka
authors.forename: Masato
authors.initials: M
authors.lastname: Kasahara
authors.forename: Shigeki
authors.initials: S
authors.lastname: Miyata
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Okamura
authors.forename: Michihiro
authors.initials: M
authors.lastname: Nasu
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tanemoto
authors.forename: Koichi
authors.initials: K
authors.lastname: Arinaga
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Hisashi
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Sakata
mesh_terms: D000368:Aged; D044466:Asian People; D002423:Cause of Death; D015331:Cohort Studies; D001026:Coronary Artery Bypass / Q000401:mortality / Q000706:statistics & numerical data; D003327:Coronary Disease / Q000150:complications* / Q000601:surgery*; D048909:Diabetes Complications / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000628:therapy*; D003927:Diet, Diabetic; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007328:Insulin / Q000008:administration & dosage; D007564:Japan / Q000453:epidemiology; D008297:Male; D015999:Multivariate Analysis; D011300:Preoperative Care; D012189:Retrospective Studies; D012306:Risk; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin