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Off-pump CABG in diabetic patients: does insulin dependency matter?
Feza Nurozler1, Tolga Kutlu, Güngör Küçük
1Division of Cardiovascular Surgery, Central Hospital, Izmir, Turkey. fnurozler@yahoo.com
Scandinavian Cardiovascular Journal : SCJ
|March 17, 2007
Summary
Insulin-dependent diabetes patients experienced more postoperative complications, including stroke and wound infections, after off-pump CABG surgery. They also had longer intensive care unit stays compared to non-insulin-dependent diabetic patients.
Area of Science:
- Cardiovascular Surgery
- Diabetology
- Intensive Care Medicine
Background:
- Diabetes mellitus is a significant comorbidity in patients undergoing coronary artery bypass grafting (CABG).
- Insulin dependency in diabetic patients may influence surgical outcomes.
- Off-pump coronary artery bypass grafting (OPCAB) is a surgical technique with specific patient considerations.
Purpose of the Study:
- To analyze the influence of insulin dependency on short-term outcomes after OPCAB in patients with diabetes.
- To compare postoperative complication rates and hospital stay between insulin-dependent and non-insulin-dependent diabetic patients undergoing OPCAB.
Main Methods:
- Retrospective cohort study involving 148 diabetic patients undergoing OPCAB.
- Patients were divided into two groups: insulin-dependent (Group I) and non-insulin-dependent (Group II).
- Analysis of preoperative data, in-hospital mortality, major and minor postoperative complications, and duration of intensive care unit (ICU) and hospital stay.
Main Results:
- No significant difference in in-hospital mortality between groups.
- Insulin-dependent diabetics had a higher incidence of stroke (p=0.027), sternal wound infection (p=0.036), and atrial arrhythmia (p=0.021).
- Group I patients showed a trend towards higher renal dysfunction (p=0.069) and significantly longer ICU stays (p=0.038).
Conclusions:
- Insulin dependency is associated with an increased risk of major postoperative complications after OPCAB.
- Diabetic patients requiring insulin have longer ICU durations following OPCAB.
- These findings suggest careful perioperative management is crucial for insulin-dependent diabetics undergoing OPCAB.
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