Impact of diabetes mellitus on old patients undergoing coronary artery bypass grafting

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Qiang Ji1, Yunqing Mei, Xisheng Wang

  • 1Department of Thoracic Cardiovascular Surgery, Tongji Hospital, Tongji University, Shanghai, P.R. China.

International Heart Journal
|December 3, 2009
PubMed

Insights

Elderly patients with diabetes undergoing coronary artery bypass grafting (CABG) face similar mortality and morbidity rates as nondiabetics. The primary increased risk for diabetics is deep sternal wound infection, suggesting good outcomes are achievable.

Area of Science:

  • Cardiovascular Surgery
  • Diabetology
  • Geriatric Medicine

Background:

  • Coronary artery bypass grafting (CABG) is a common procedure for cardiovascular disease.
  • Outcomes in elderly diabetic patients undergoing CABG require further investigation.
  • Diabetes is a significant comorbidity impacting surgical results.

Purpose of the Study:

  • To compare outcomes of elderly diabetic versus nondiabetic patients after isolated CABG.
  • To identify specific risks and benefits for diabetic patients undergoing CABG.
  • To evaluate the impact of diabetes on postoperative complications and mortality.

Main Methods:

  • Retrospective analysis of pre-, intra-, and postoperative data.
  • Inclusion of all CABG patients over 65 years of age from January 2004 to December 2008.
  • Definition of diabetes based on medication requirements (oral or insulin).

Main Results:

  • Diabetic patients (over 65) were less likely to have had prior percutaneous coronary intervention (PCI) and more likely to undergo cardiopulmonary bypass (CPB).
  • Elderly diabetic patients showed a significantly higher rate of deep sternal wound infection (OR = 2.76).
  • Other morbidities and mortality rates were comparable between elderly diabetic and nondiabetic patients.

Conclusions:

  • Elderly diabetic patients undergoing isolated CABG experience comparable overall outcomes to their nondiabetic counterparts.
  • Deep sternal wound infection is a key complication to monitor in this population.
  • Excellent results following CABG can be anticipated for elderly diabetic patients.

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