Takeaway
- Diabetes mellitus (DM) does not significantly predict in-hospital mortality following coronary artery bypass grafting (CABG) or combined in-hospital postoperative events after adjusting for factors including surgical status, age, previous CABG, peripheral arterial disease, female sex, heart failure, lung disease, dialysis, ejection fraction, and previous myocardial infarction.
- Diabetes does predict permanent stroke, surgical site infection, and new renal failure.
Why this matters
- Previous study results were mixed on whether diabetes independently predicts CABG complications.
Study design
- Single-centre study of 5013 post-CABG patients with diabetes and 6577 without; 32% with diabetes were insulin-treated.
- In-hospital postoperative events included permanent stroke, surgical site infection, pneumonia, prolonged ventilation, renal failure, gastroenterology events, multisystem failure, reoperation for bleeding, Afib, or cardiac arrest.
- Permanent stroke defined as confirmed neurologic deficit unresolved within 24 hours, including ischemic, haemorrhagic, and embolic strokes.
- Funding: EVMS-Sentara Healthcare Analytics and Delivery Science Institute, Virginia.
Key results
- In multivariable analysis, diabetes status did not significantly predict in-hospital mortality (P=.206) or combined in-hospital events (P=.545).
- Compared with no diabetes, having diabetes was significantly associated with permanent stroke (unadjusted analysis, P<.001).
- In multivariate analysis, insulin-treated diabetes significantly predicted surgical site infection (P=.036) and new renal failure (P<.001) vs no diabetes.
Limitations
- No information about diabetes type/duration, HbA1c levels.
- Single centre.
References
References
