Early and mid-term outcome of CABG surgery in diabetic and non-diabetic patients in a tertiary care hospital in Bangladesh
Background: Previous trials showed that diabetic patients had worse in-hospital and long term outcome after coronary artery bypass grafting (CABG) than non diabetic ones. However, the majority of such studies was carried out in western countries and limited information is available for the Asian population.
Objective: The present study was intended to determine the impact of diabetes on early and mid-term outcome among patients undergoing CABG surgery in a tertiary care hospital in Bangladesh.
Methods: This study was performed at Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh, from January to June 2014. Based on enrollment criteria, 202 patients (115 diabeticsand 87 non-diabetics) were enrolled and evaluated for their early outcome (within 30 days of operation) and midterm (after 30 days post-operatively). Patients with known diabetes or preoperative fasting blood sugar ≥6.4 mmol/L or random blood sugar ≥11.1 mmol/L were considered as diabetics. The outcome measures were ICU stay, reopening for bleeding, atrial fibrilation, cardiac arrest, total hospital stay, left ventricular ejection fraction and mortality.
Results: Diabetic patients in this study had higher prevalence of hypertension, hyperlipidaemia, and renal failure. The diabetic and the non diabetic groups received a mean number of grafts of 3.2±1.06 and 2.81±1.21, respectively, Postoperative mortality in diabetic and non-diabetic patients at early and mid-term were not significantly different in univariate analysis (4.3% vs. 2.3%, p= 0.352) and (2.6 % vs. 2.3%,p = 0.630) respectively. The mean intensive care unit (ICU) stay in diabetic and non-diabetic were same (3.5days) but total hospital stay was significantly higher in the former group (one day or more). Re-opening for bleeding, atrial fibrilation and cardiac arrest in ICU were found higher in DM than those in non-DM group (28.7%vs.20.7%,10.4% vs. 8% and 4.2% vs.1.1% respectively).
Conclusion: Although the mortality rate of diabetic patients following CABG surgery was in significantly higher than their non-diabetic counterparts. Morbidity was also a bit higher. Strict perioperative glyacemic control could reduce morbidity and mortality in diabetic patients undergoing CABG.
97 ONLINE VIEW
Copyright (c) 2019 BMRC
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms.
Authors retain copyright and grant the journal right of first publication.
Articles in the Bangladesh Medical Research Council Bulletin are licensed under a Creative Commons Attribution 4.0 International License (CC-BY) that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).