Coronary Artery DiseaseComparison of Factors Associated With 30-Day Mortality After Coronary Artery Bypass Grafting in Patients With Versus Without Diabetes Mellitus
Section snippets
Methods
This study is predicated on a database collected in a national Israeli outcome study of CABG. The investigation included most patients who underwent isolated CABG in each of the 14 centers that performed open-heart operations in Israel during 1994. The choice of candidate-predictive variables for early mortality was based on a review of published reports and on the definitions of a panel of clinical experts. Cardiac catheterizations were performed at the participating or referring institutions
Results
The study comprised 1,034 diabetic patients receiving either oral hypoglycemics or insulin, and 3,350 patients with no history of diabetes. Because of incomplete data, 291 patients were excluded.
Crude, unadjusted 30-day mortality was 5.0% in diabetics and 2.5% in nondiabetics (p <0.001). Crude mortality rates by gender in nondiabetics were 2.3% for men and 3.5% for women (p = NS); among diabetic patients, crude mortality rates by gender were 3.7% for men and 8.3% for women (p = 0.002).
Diabetics
Discussion
The main result of this study was that female gender was found to be an independent risk factor for 30-day mortality among diabetic patients undergoing CABG, but not among nondiabetic patients. This finding, by way of multivariate analysis controlling for possible confounders, supports the observation made by Carey et al[5] in a univariate analysis; among 1,335 patients who underwent CABG they found excess crude in-hospital mortality among female diabetic patients (11% vs 3.6% for male
Acknowledgements
Acknowledgment:
We thank Haya R. Rubin, MD, for her thoughtful comments and help in editing this manuscript.
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The Israeli study of outcomes after coronary artery bypass grafting 1994: Azay Appelbaum; Nima Amit; Yitzhak Berlovitz; Dani Biteran; Amram J. Cohen; Elieser Kaplinsky; Jacob Lavee; Gideon Merin; Simcha Milo; Gideon Uretzky; Gideon Sahar; Arie Schachner; Aram K. Smolensky; Bernardo Vidne; Vladimir Yakirevitch.