Diabetes complications and adverse health outcomes after coronary revascularization.
OBJECTIVE
To examine effects of diabetes complications on health outcomes following coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI), comparing outcomes for patients with diabetes complications to those without diabetes complications.


METHODS
Retrospective analysis of discharge data for 61,566 patients with diabetes age 45 or older who had CABG or PCI in 2007 in United States community hospitals, using data from the Nationwide Inpatient Sample. Analysis included propensity score-adjusted logistic regression.


RESULTS
Of all patients, 21.2% of the weighted sample had diabetes complications. Older patients, Blacks and Hispanics, and those with greater illness severity were more likely to have diabetes complications. Unadjusted rates of in-hospital mortality, postoperative stroke, and renal failure were higher for patients with diabetes complications (rate ratios 2.2, 1.8, and 9.8, respectively; all p<0.0001). In adjusted results, having diabetes complications was associated with higher odds of in-hospital mortality (odds ratio, OR 1.62, 95% confidence interval, CI 1.37-1.91) and renal failure (OR 3.03, CI 1.71-5.39). Compared to CABG, PCI was associated with extra risk of postoperative renal failure for those with diabetes complications.


CONCLUSIONS
Among patients with diabetes having revascularization, those with diabetes complications have higher risks of in-hospital death and renal failure irrespective of having CABG or PCI.
Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, United States. Electronic address: bekezue@uncc.edu.
Bola F
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Ekezue
Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, United States.
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Laditka
Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, United States.
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Laditka
Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, United States.
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Studnicki
Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC 28223, United States.
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Blanchette
D000368:Aged; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003327:Coronary Disease / Q000601:surgery; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000209:etiology* / Q000401:mortality; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011183:Postoperative Complications / Q000401:mortality; D051437:Renal Insufficiency / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000401:mortality; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States
Administrative data; Coronary by-pass surgery; Diabetes complications; Percutaneous coronary intervention; Propensity score