In-hospital Complications of Coronary Artery Bypass Surgery in Diabetic and Non Diabetic Patients with the Use of Heart Lung Machine

Background and Objectives: The coronary artery bypass grafting (CABG) operation has perhaps become one of extensively studied operation in the history of surgery. It has been shown to be highly effective for the relief of ischemic heart diseases, and to have prolonged life in some subsets of patients. Diabetes mellitus is an established independent risk factor for causing significant morbidity and mortality after coronary artery bypass grafting. The objective of this study was to compare the complications after CABG in diabetic and non-diabetic patients during hospital stay in the first 3 to 4 days. Methodology: It was a prospective study with three days follow up of 200 patients undergoing CABG with the use of heart lung machine (on pump). Patients were divided in to two groups i.e. diabetics and non-diabetics. Independent sample t-test was used to compare the means of two groups in pre and postoperative conditions while chi-sqaure test was used for bivariate analysis to confirm the significant association of complications for two groups. p-value ≤ 0.05 was considered as significant. Results: The mean age of diabetic patients was 56.10 ± 8.63 years and mean age of non-diabetics was 54.78 ± 11.17 years. Of all the data analyzed there was an overall male predominance. The two groups of patients were similar with regard to ejection fraction pre and post operatively. There was a significant difference in postoperative urea and creatinine levels in both groups. The types of complications within the two groups differed in that the immediate renal dysfunction (36%), bleeding (14%)and intra-aortic balloon pump use (17%) were significantly greater (p-value<0.05) in diabetic patients compared to the non-diabetics (13%, 8%and 7% respectively). Occurrence of postoperative atrial fibrillation, low cardiac output syndrome and prolong ventilator support were statistically insignificant for both groups. Conclusion: Diabetics have worst hospital and long term outcome after coronary artery bypass grafting in terms of immediate renal dysfunction, bleeding and intra-aortic balloon pump use.