Previous studies have shown that diabetes mellitus (DM) is a risk factor for postoperative
coronary artery bypass grafting (CABG) complications. More contemporary studies are
needed to guide revascularization decisions in DM patients. We performed a single-center
study of patients who underwent CABG. Patients with no DM were compared with patients
with DM, subgrouped according to whether or not DM was treated with insulin before
admission (Insulin and No Insulin Groups). Multivariable logistic regression was used
to determine whether DM was a significant predictor of mortality, combined postoperative
events, and specific postoperative complications after controlling for other predictive
clinical variables. Of 11,590 consecutive patients who underwent CABG, 5,013 (43%)
had DM and 6,577 (57%) had no DM. Of the patients with DM, 3,433 (68%) were not treated
with insulin and 1,580 (32%) were treated with insulin before admission. Multivariable
logistic regression analyses showed that DM was not significantly associated with
in-hospital mortality or combined postoperative events after considering other clinical
variables. The No Insulin Group was significantly associated with stroke, and the
Insulin Group was significantly associated with surgical site infection and new renal
failure. In conclusion, this study of consecutively treated CABG patients shows that
DM is not a predictor of in-hospital mortality or combined in-hospital postoperative
events after adjusting for other clinical factors. DM is a predictor of permanent
stroke, surgical site infection, and new renal failure. These findings may help with
case selection and management of DM patients undergoing CABG.
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Article info
Publication history
Published online: August 07, 2019
Received in revised form:
July 23,
2019
Received:
June 4,
2019
Footnotes
Funding: This project was partially funded by a grant from the EVMS-Sentara Healthcare Analytics and Delivery Science Institute, Norfolk, Virginia.
Identification
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© 2019 Elsevier Inc. All rights reserved.
