Perioperative Morbidity in Diabetics Requiring Coronary Artery Bypass Surgery

Clement, Ronald; Rousou, John A.; Engelman, Richard M.; Breyer, Robert H.

doi:10.1097/00132586-198906000-00022

Cited by 3 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Investigators have evaluated the presence or absence of diabetes mellitus [17,22,24,25], insulin treatment [23], and perioperative blood glucose levels [26] as risk factors for SSI. It is not known which of these features most strongly predict the development of SSI in patients with diabetes mellitus.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Radial Artery Harvest Site Infection Following Coronary Artery Bypass Graft Surgery

Trick

Scheckler

Tokars

et al. 2000

Clinical Infectious Diseases

View full text Add to dashboard Cite

Radial arteries increasingly are used during coronary artery bypass graft (CABG) surgery. Although risk factors for saphenous vein harvest site infection (HSI) have been reported, rates of and risk factors for radial artery HSI are not well established. We compared rates of radial artery HSI that were detected by 2 surveillance methods, regular and heightened. Risk factors were determined by a case-control study. We identified 35 radial artery HSIs ("case sites") in 26 case patients. The radial artery HSI rate was significantly higher during heightened surveillance than during routine surveillance (12.3% vs. 3.1%, respectively; P=.002). Multivariate analysis showed that diabetes mellitus with a preoperative glucose level >/=200 mg/dL (odds ratio [OR], 4.4; P=. 01) and duration of surgery >/=5 h (OR, 3.1; P=.02) were independent risk factors for radial artery HSI. Infection is a common complication of radial artery harvesting for CABG surgery, and infection rates are dependent on the intensity of surveillance. We identified preoperative hyperglycemia and surgery duration as independent risk factors for radial artery HSI.

show abstract

Section: Discussionmentioning

confidence: 99%

Risk Factors for Radial Artery Harvest Site Infection Following Coronary Artery Bypass Graft Surgery

Trick

Scheckler

Tokars

et al. 2000

Clinical Infectious Diseases

View full text Add to dashboard Cite

show abstract

“…Da Diabetiker häufiger einen perioperativen Schlaganfall erleiden und die herznahen thorakalen Gefäße häu-figer verkalkt sind als bei Nichtdiabetikern [29], ist eine genaue Kenntnis des Karotisbefundes und des Verkalkungsgrades der Aorta ascendens unerlässlich. Eine präoperative Evaluation der Karotiden mittels Doppler-oder Duplexsonographie ist grundsätzlich notwendig [30].…”

Section: Therapiekonzept Der Chirurgischen Revaskularisation Bei Diabunclassified

Koronarchirurgie bei Diabetes mellitus

Hausmann

Hetzer

2004

Herz

View full text Add to dashboard Cite

Patients with coronary artery disease (CAD) and diabetes mellitus have an increased risk of mortality when undergoing either interventional or surgical revascularization. However, the rate of necessary reinterventions is significantly lower after surgical revascularization than after percutaneous transluminal coronary angioplasty (PTCA). As yet, no results of long-term follow-up after stent implantation are available. The risk for a patient with diabetes mellitus and CAD of dying of myocardial infarction after a bypass operation is significantly lower than after PTCA. Bypass operation with sternotomy in patients with diabetes mellitus carries, however, an increased risk of postoperative mediastinitis, especially when both internal thoracic arteries are used for "totally arterial" revascularization. For this reason the internal thoracic artery should be used only unilaterally in surgical revascularization in these patients. Preoperative and postoperative stabilization of the blood sugar level is very important. Sclerosis of the vessels in close proximity to the heart (ascending aorta, carotid arteries) must be clarified preoperatively. The operation should be carried out particularly carefully, with the wound area kept as small as possible. Reexploration should definitely be avoided. If these guidelines are followed, surgical revascularization in patients with CAD and diabetes mellitus can achieve very good results.

show abstract

“…Recently published data of mostly non-diabetic post operative patients, demonstrated an impressive 34% decrease in mortality of patients randomized to strict glucose control (80-110 mg/dl) during their stay in the critical care unit [15]. Contrary to the above, a number of investigators report little or no increase in morbidity or mortality among patients with diabetes undergoing CABG [2,16,17].…”

mentioning

confidence: 99%

Multidisciplinary Intervention for Control of Diabetes in Patients Undergoing Coronary Artery Bypass Graft (CABG)

Cohen

Dankner

Chetrit

et al. 2003

Cardiovascular Surgery

View full text Add to dashboard Cite

In Israel, as elsewhere, diabetes mellitus is highly prevalent among patients undergoing coronary artery bypass graft (CABG). The bulk of evidence, derived retrospectively, suggests that poor control of diabetes predisposes to complications of CABG and increases mortality; but the findings in a number of studies fail to support that impression. Anticipating a prospective investigation designed to resolve this issue, we have carried out a preliminary study of 147 consecutive patients with diabetes who were hospitalized for elective CABG during 1998. Our objective was to determine how well and how often diabetes could be controlled in accordance with selected metabolic goals in the brief interval between hospital admission and surgery and during the operation itself and in the postoperative period. The task was undertaken by a multidisciplinary team, in cooperation with the Department of Cardiac Surgery. The metabolic goals were: fasting blood glucose consistently between 65–140 mg/dl before and after surgery and 120–180 mg/dl at the time of surgery; and postprandial blood glucose consistently < 180 mg/dl. These goals were achieved in 18.1% of fasting blood glucose measurements before and after surgery, 22.1% of preprandial and 14.6% of postprandial blood glucose levels consistently < 180 mg/dl. There were no clinical episodes of hypoglycemia. Due to the low incidence of major infection related complications (deep sternal wound infection in only 3 patients (2.0%)) no significant statistical conclusions on the relations between glucose control and these complications could be drawn. The means of all values of FBG and of hemoglobin A1c were significantly higher among patients with complications ( n=49) than in those without ( P=0.01).

show abstract

Perioperative Morbidity in Diabetics Requiring Coronary Artery Bypass Surgery

Cited by 3 publications

References 0 publications

Risk Factors for Radial Artery Harvest Site Infection Following Coronary Artery Bypass Graft Surgery

Risk Factors for Radial Artery Harvest Site Infection Following Coronary Artery Bypass Graft Surgery

Koronarchirurgie bei Diabetes mellitus

Multidisciplinary Intervention for Control of Diabetes in Patients Undergoing Coronary Artery Bypass Graft (CABG)

Contact Info

Product

Resources

About