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Ann Thorac Surg 1988;46:321-323
© 1988 The Society of Thoracic Surgeons

Articles

Perioperative Morbidity in Diabetics Requiring Coronary Artery Bypass Surgery

Ronald Clement, M.D., John A. Rousou, M.D.*, Richard M. Engelman, M.D., Robert H. Breyer, M.D.

From the Bay state Medical Center, Springfield, MA

Accepted for publication March 15, 1988.

* Address reprint requests to Dr. Rousou, Baystate Medical Center, 759 Chestnut St, Springfield, MA 01107.

We retrospectively evaluated the operative results in 384 patients with diabetes mellitus operated on for ischemic coronary artery disease over a six-year period compared with a random group of 396 patients selected from 2,069 nondiabetic patients who underwent operation during the same study period. In our analysis of 13 preoperative and 5 intraoperative variables, diabetics revealed a significantly increased incidence of hypertension (p < 0.05) and a smaller proportion of men (p < 0.05). All other variables were not significantly different. The incidence of perioperative myocardial infarction, renal failure, neurological sequelae, leg infections, or thromboembolic events was similar in diabetic and nondiabetic patients. Hospital stay, however, was significantly increased in the diabetic group (p < 0.05). The diabetic patients requiring intraaortic balloon counterpulsation had a significantly higher incidence of all postoperative complications analyzed compared with diabetics without balloon support (p < 0.01), whereas the nondiabetic subset requiring intraaortic balloon counterpulsation exhibited only a significantly higher incidence of renal failure (p < 0.01) and neurological complications (p < 0.05). These results indicate that diabetes per se does not significantly increase morbidity in coronary bypass surgery.




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