Non-infective morbidity in diabetic patients undergoing coronary and heart valve surgery.

OBJECTIVE: Studies of postoperative morbidity in diabetics have focussed on infection; however, autonomic and cardiovascular complications of diabetes potentially increase the risk for non-infective morbidity. We sought to investigate major non-infective early postoperative complications in diabetic patients.

METHODS: We identified diabetics who underwent CABG and/or valve operation from 1998 through 2007, and compared their clinical characteristics and outcome with a contemporaneous cohort of non-diabetic patients.

RESULTS: The demographic characteristics of 1145 diabetics were similar to 5534 non-diabetic patients (mean age 66+/-9 years vs 66+/-10 years, p=0.45, female 27.5% vs 26.7%, p=0.59, respectively). Class III/IV angina symptoms (43.9% vs 34.9%, p<0.0001), intravenous nitrates therapy (10.4% vs 6.6%, p<0.0001), heart failure (24.8% vs 20.4%, p=0.001), prior myocardial infarction (37% vs 31%, p<0.0001), ejection fraction
CONCLUSIONS: Diabetic patients present for surgery with higher prevalence of cardiovascular risk factors and are more likely to develop major non-infective complications, including cardiac, renal and neurological dysfunction, even though diabetes does not directly influence non-infective postoperative morbidity following CABG and/or valve operations.