Abstract
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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