Diagnosed Diabetes and In-Hospital Mortality after Coronary Artery Bypass Grafting Open Access

Ward, Rebecca Jane (2012)

Permanent URL: https://etd.library.emory.edu/concern/etds/t722h8949?locale=en


Background-Data are conflicting over whether patients with diagnosed diabetes mellitus (DM)
have higher in-hospital mortality than patients without diabetes after coronary artery bypass
grafting (CABG) surgery. Long-term survival is decreased in patients with diabetes after CABG. We
hypothesized that patients with diabetes have higher in-hospital mortality rates after CABG.
Methods and Results-We studied 11,001 patients (38.8% with diagnosed DM) included in the
Society of Thoracic Surgeons database who received CABG at 3 clinical centers January 1, 2002 and
December 31, 2010. Patients with DM were more likely to be non-white, obese, and female. DM
diagnosis was related to in-hospital mortality after CABG, but this relationship was dependent on age
and race. Non-white individuals under 55 years of age were 14 times more likely to die in-hospital
post-CABG if they were diagnosed with DM than if the were not diagnosed with DM (AOR= 14.10,
95% CI 1.77-112.28). White individuals under 55 years of age were no more likely to die in-hospital
dependent on positive DM diagnosis (AOR= 1.25, 95% CI 0.25-8.01). Diagnosed DM in individuals
between 55 and 69 years of age was not associated with increased likelihood of in-hospital mortality
(AOR= 0.86, 95% CI 0.49-1.51) or in individuals over 70 years of age (AOR 0.88, 95% CI 0.56-1.38).
Conclusions- Diagnosed DM was associated with higher in-hospital mortality, but this association
was limited to young (under 55 years of age) non-whites. Diagnosed DM was not associated with
increased in-hospital mortality in whites, and individuals over 55 years of age. Additional
investigation is needed to determine why in-hospital mortality is higher in those diagnosed with
diabetes after CABG, with particular focus on younger non-white individuals.

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