Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 3 de 3
Filter
1.
Circulation ; 112(16): 2397-402, 2005 Oct 18.
Article in English | MEDLINE | ID: mdl-16230496

ABSTRACT

BACKGROUND: Numerous studies have shown that diabetes mellitus (DM) is not identified and, consequently, inadequately treated in a substantial proportion of the patients in the general population. We know very little about the extent and the consequences of undiagnosed diabetes in the risk group of patients with coronary heart diseases. The objective of this study was therefore to determine the prevalence and the risks of undiagnosed DM among patients with coronary artery bypass. METHODS AND RESULTS: The data of 7310 patients who have undergone coronary bypass operations between 1996 and 2003 were analyzed. Depending on their diagnosis on admission and their fasting plasma glucose (FPG) level, these patients were classified as known diabetics, undiagnosed diabetics (FPG > or =126 mg/dL), or as nondiabetics (FPG <126 mg/dL) and were compared in terms of their preoperative, intraoperative, and postoperative characteristics. Among the patients with coronary bypass that we examined, we found a prevalence of diagnosed diabetics of 29.6%. The prevalence of patients with undiagnosed DM (FPG > or =126 mg/dL) was 5.2%. In comparison with the other groups (non-DM versus undiagnosed DM versus known DM), the undiagnosed diabetics more frequently required resuscitation (1.7% versus 4.2% versus 1.5%; P<0.01) and reintubation (2.1% versus 5.0% versus 3.5%; P<0.01) and often showed a longer period of ventilation >1 day (5.6% versus 10.5% versus 7.4%; P<0.01). Perioperative mortality rate was highest in this group (0.9% versus 2.4% versus 1.4%; P<0.01). CONCLUSIONS: This study is the first to publish the prevalence of undiagnosed diabetes mellitus in cardiac surgery. During the perioperative and postoperative courses, these patients displayed a substantially higher morbidity and mortality rate.


Subject(s)
Coronary Artery Bypass/methods , Diabetes Mellitus/epidemiology , Aged , Blood Glucose/analysis , Diabetes Mellitus/blood , Female , Humans , Male , Prevalence , Retrospective Studies , Risk Factors
2.
J Thorac Cardiovasc Surg ; 135(5): 1047-53, 2008 May.
Article in English | MEDLINE | ID: mdl-18455583

ABSTRACT

OBJECTIVES: In the past few years there has been increasing evidence that the respiratory function of patients with diabetes is impaired in the course of their disease. The objective of this article was to investigate whether patients with diabetes are particularly at risk of pulmonary complications during the perioperative stage of coronary bypass surgery. METHODS: The data of 8555 patients who had undergone coronary bypass operations in the years between 1996 and 2004 were analyzed. Depending on their diagnosis on admission and their fasting plasma glucose levels, these patients were classified as having "no diabetes" (fasting plasma glucose level < 126 mg/dL), "undiagnosed diabetes" (glucose level > or = 126 mg/dL), "oral therapy diabetes," or "insulin-treated diabetes." The 3 diabetic groups were compared with the nondiabetic group in terms of the preoperative and postoperative characteristics. RESULTS: The reintubation rate among patients with undiagnosed diabetes (4.6%) and among those with insulin-treated diabetes (4.5%) was significantly higher than that of nondiabetic patients (1.8%; P < .01). The proportion of patients who required respiration for periods longer than 1 day was also significantly higher among patients with undiagnosed diabetes (9.9%) and those with insulin-treated diabetes (8.6%) than among the nondiabetic patients (4.8%; P < .01). The regression models show that unidentified diabetes and insulin-treated diabetes constitute independent risk factors for perioperative pulmonary complications. CONCLUSIONS: Patients with undiagnosed and insulin-treated diabetes have a higher risk of having pulmonary complications in the perioperative course of coronary bypass operations than do nondiabetic patients. These results may be explained if one considers the lung as another target organ of the diabetic disease.


Subject(s)
Coronary Artery Bypass/adverse effects , Diabetes Complications , Lung Diseases/etiology , Aged , Female , Humans , Male , Middle Aged , Risk Factors
SELECTION OF CITATIONS
SEARCH DETAIL