Effect of preoperative glycemic status on postoperative complications of coronary artery bypass graft surgery in patients with diabetes

2021 ◽  
Author(s):  
Abbas Andishmand ◽  
Seyed Khalil Froozannia ◽  
Seyedeh-Mahdieh Namayandeh ◽  
Seyed Jalil Mirhosseini ◽  
Maryamalsadat Salami ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Coronary Artery ◽  
Postoperative Complications ◽  
Hospital Mortality ◽  
Coronary Artery Bypass ◽  
Hba1c Level ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Diabetic Patients ◽  
Glycemic Status

Objectives: Diabetes mellitus is one of the major risk factors for cardiovascular disease, and increases the risk of postoperative mortality. HbA1c is a measure of glycemic control. This study aimed to determine the effect of glycemic status on the complications of coronary artery bypass graf (CABG) surgery in diabetic patients. Methods: This cross-sectional study was performed on 300 diabetic patients including 186 (62%) men and 114 (38%) women who underwent CABG from March 2010 to August 2011 and selected via census method. Preoperative blood glucose control status was determined using HbA1c levels, and the patients were evaluated for postoperative in-hospital complications. Results: The mean age of the patients was 62.3±  6.9 years. In-hospital mortality was 1.0% (3/300). New-onset atrial fibrillation was the most common complication (35%). HbA1c level above 7.5% was a predictor of in-hospital mortality after CABG (unadjusted odds ratio 1.9, 95٪ CI: 1.1-3.2, p = 0.006). After stratifying analysis with Chi-sqaure test we found that gender history of myocardial infarction had no significant relationship with HbA1c level in two groups with or without complication. Conclusions: Long-term uncontrolled blood glucose before CABG is associated with increased postoperative complications. Preoperative HbA1c measurement can be a predictor of high-risk patients.

Obesity in Diabetic Patients Undergoing Coronary Artery Bypass Graft Surgery Is Associated with Increased Postoperative Morbidity

2006 ◽  
Vol 104 (3) ◽  
pp. 441-447 ◽  
Author(s):  
Wei Pan ◽  
Katja Hindler ◽  
Vei-Vei Lee ◽  
William K. Vaughn ◽  
Charles D. Collard
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Coronary Artery Bypass Surgery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Postoperative Outcomes ◽  
Diabetic Patients ◽  
Artery Bypass Graft ◽  
Increased Risk

Background Despite the fact that obesity is a known risk factor for cardiovascular disease, many studies have failed to demonstrate that obesity is independently associated with an increased risk of cardiovascular morbidity and mortality in nondiabetic patients undergoing coronary artery bypass graft surgery. The authors investigated the influence of obesity on adverse postoperative outcomes in diabetic and nondiabetic patients after primary coronary artery bypass surgery. Methods A retrospective cohort study of patients undergoing primary coronary artery bypass surgery (n = 9,862) between January 1995 and December 2004 at the Texas Heart Institute was performed. Diabetic (n = 3,374) and nondiabetic patients (n = 6,488) were classified into five groups, according to their body mass index: normal weight (n = 2,148), overweight (n = 4,257), mild obesity (n = 2,298), moderate obesity (n = 785), or morbid obesity (n = 338). Multivariate, stepwise logistic regression was performed controlling for patient demographics, medical history, and preoperative medications to determine whether obesity was independently associated with an increased risk of adverse postoperative outcomes. Results Obesity in nondiabetic patients was not independently associated with an increased risk of adverse postoperative outcomes. In contrast, obesity in diabetic patients was independently associated with a significantly increased risk of postoperative respiratory failure (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.41-3.61; P < 0.001), ventricular tachycardia (OR, 2.27; 95% CI, 1.18-4.35; P < 0.02), atrial fibrillation (OR, 1.56; 95% CI, 1.03-2.38; P < 0.04), atrial flutter (OR, 2.38; 95% CI, 1.29-4.40; P < 0.01), renal insufficiency (OR, 1.66; 95% CI, 1.10-3.41; P < 0.03), and leg wound infection (OR, 5.34; 95% CI, 2.27-12.54; P < 0.001). Obesity in diabetic patients was not independently associated with an increased risk of mortality, stroke, myocardial infarction, sepsis, or sternal wound infection. Conclusion Obesity in diabetic patients is an independent predictor of worsened postoperative outcomes after primary coronary artery bypass graft surgery.

scholarly journals Trends in per-operative parameters and postoperative complications associated with coronary artery bypass graft surgery (CABG); A four-year retrospective study

2021 ◽  
Vol 37 (7) ◽  
Author(s):  
Azam Jan ◽  
Muhammad Khizar Hayat ◽  
Mohammad Ahmed Arsalan Khan ◽  
Rafi Ullah
Keyword(s):  
Retrospective Study ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Postoperative Complications ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Tertiary Care ◽  
Bypass Grafting ◽  
Artery Bypass Graft

Objective: To determine the patterns of per-operative parameters and early outcomes of patients that underwent CABG surgery during a four-year period. Methods: This is a cross-sectional descriptive study conducted in a tertiary care of hospital from November 2020 to January 2021. All the patients that underwent the isolated coronary artery bypass grafting (CABG) procedure were included in the study from June 2017 till June 2020. Data was collected on a data extraction form and stored in SPSS format which was analyzed for qualitative statistics keeping p<0.05 as significant. All the results were represented in the form of tables. Results: A total of 1,613 patients were operated upon for Coronary Artery Bypass Grafting (CABG) procedure during the study period with 1,222 (75.8%) males and 391 (24.2%) females. Dyslipidemia (71.8%) was the most common risk factor. The average perfusion time decreased only slightly (~1 minute) from 96.01 minutes to 95.07 minutes (2017 to 2020). This change however was not significant (p=0.301). The rate of Left Internal Mammary Artery (LIMA) use stayed relatively stable over the 4-year period fluctuating between 88.7% and 92.9% (p=0.360). The average initial ICU stay (in hours), drain at 12 hours and 24 hours stays almost the same. The rate of mortality peaked in 2018 (4.76%) and subsequently fell to 3.57% by 2020. Conclusion: More males underwent CABG surgery at this tertiary care hospital and the overall complication rate and per-operative parameters improved over the years. The non-risk stratified mortality in this study was found to be higher than developed nations. doi: https://doi.org/10.12669/pjms.37.7.4315 How to cite this:Jan A, Hayat MK, Khan MAA, Ullah R. Trends in per-operative parameters and postoperative complications associated with coronary artery bypass graft surgery (CABG); A four-year retrospective study. Pak J Med Sci. 2021;37(7):---------.  doi: https://doi.org/10.12669/pjms.37.7.4315 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Blood Glucose Profile Post Coronary Artery Bypass Graft in Rsup H. Adam Malik Medan

2018 ◽  
Vol 5 (1) ◽  
pp. 3470-3472
Author(s):  
Farhan Syarif ◽  
Marshal . ◽  
Doddy Prabisma Pohan
Keyword(s):  
Blood Glucose ◽  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Glucose Level ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Artery Bypass Graft ◽  
Significant Difference

Cardiopulmonary bypass (CPB) is widely used for systemic and oxygenated systemic settings during open heart surgery. (Simon L, 2004) To date there is yet to be found a definitive biochemical marker that can be considered prognostic in patients who subside. using a CPB machine. Hyperglycemia is defined as a glucose level above the normal physiological range. Normal blood glucose level is 70-120 mg and levels > 120 mg/dL is a diagnostic level for diabetes. During CPB and coronary artery bypass off-pump (OPCAB), most patients tend to have elevated blood glucose levels despite no previous diabetes medical history. This study uses a descriptive study design study with a retrospective approach. The study was conducted in the Division of Cardiac and Cardiac Surgery of the Department of Surgery of the Faculty of Medicine USU/ RSUP H. Adam Malik Medan. The study was conducted after the proposal was approved. The population in this study were patients who performed Coronary Artery ByPass Graft surgery using Cardiopulmonary Bypass (CBP) at RSUP H. Adam Malik Medan in 2016 (01 January - 31 December 2016). The study involved patients who performed Coronary Artery ByPass Graft surgery using a CPB machine in RS. Haji Adam Malik Medan. The number of research subjects was 41 people. . Based on sex it is seen that more men (84.3%) than women. The mean of postoperative KGD H + 3 was the highest KGD that was 218,28 + 23,5 mg / dL. The use of Humulin R is most commonly used in insulin therapy with patients with postoperative CPB hyperglycemia. Based on the ANOVA test there was a significant difference in the value of KGD in H + 1 post CPB operation compared to H + 2 post CPB operation (p = 0.013, p <0.05).

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