1.Outcome of Diabetic and Non-Diabetic Patients who underwent Coronary Artery Bypass Graft Surgery (CABG) at Chinese General Hospital and Medical Center from January 2010 to December 2016
Lenor P. Fusin-Herrera ; Rebecca Lim-Alba
Philippine Journal of Internal Medicine 2019;57(3):140-146
Introduction:
Several studies have shown that diabetes mellitus increases the risk of having adverse events after CABG. This study was conducted to compare outcome of diabetic and non-diabetic patients after CABG and to test if diabetes mellitus is the strongest predictor of adverse outcomes.
Methods:
This is a retrospective cohort study using charts review of CABG patients from January 2010 to December 2016. Odds ratio were computed to evaluate which risk factors have the strongest association with the occurrence of complications and mortality after CABG.
Results:
Our study population consists 107 non-diabetic (48%) and 114 diabetic (52%) patients. Diabetic patients have higher post-operative complications at 47% (54) than nondiabetics with 30.8% (33/107) (p-0.012). The most significant risk factor for complication occurrence was hypertension (p-0.015) (OR: 4.123). Every year added above 37 years old has a corresponding six percent increase in the odds of developing morbidity for both groups (p-0.001, OR: 1.06). Advanced age (p-0.000) (OR: 1.07), male gender (p-0.030) (OR: 3.10) and diabetes (p-0.043) (OR: 0.043) increase the risk of arrhythmia. The odds of developing pneumonia is higher among males (p-0.005) (OR:0.18) and smokers (p0.041)(OR: 3.50) in both groups. The odds of developing acute kidney injury was increased by 12% for every year added above 37 years old (p-0.035)(OR: 1.12).There is a two percent increase risk for developing acute kidney injury for mean post operative blood glucose above 110mg/dL (p0.030) (OR: 1,025).
Discussion:
Hypertension and age are significant predictors of morbidity in this study. Age related changes in cardiac physiology can be contributory. Male smokers have a higher risk of developing pneumonia in both groups pointing the significance of this risk factor. Elevated post-operative blood glucose must be addressed fully because of its association with acute kidney injury.
Conclusion
More complications are encountered among diabetic patients. However, diabetes mellitus is not the strongest predictor of mortality. Instead, age and hypertension showed higher association with adverse outcome.
Diabetes Mellitus