Morbidity and In-Hospital Mortality in Diabetic Patients Undergoing Cardiac Surgery: A Retrospective Cohort Study

Abstract

Objective: To evaluate the impact of diabetes mellitus (DM) in hospital mortality and morbidity after cardiac surgery. Materials and Methods: The authors performed a retrospective cohort study in a tertiary medical center. One thousand two hundred fifteen patients had cardiac surgery between June 2015 and July 2021, divided into two groups, 824 non-diabetic, and 391 diabetic patients. Results: In-hospital mortality rates were comparable in diabetic and non-diabetic patients at 7.2% versus 6.6% (p=0.786). However, chronic kidney disease, high American Society of Anesthesiologists physical status, preoperative arrhythmias, and non-valvular surgery were statistically significant predictors of in-hospital mortality. In-hospital morbidities were higher in diabetic patients compared with non-diabetic patients (p<0.001) with neurological complications at 11.3% versus 7% (p=0.018), pulmonary complications at 57.5% versus 37.9% (p<0.001), renal complications at 39.4% versus 17.2% (p<0.001), infectious complications at 15.9% versus 7.3% (p<0.001), and arrhythmias at 26.6% versus 17.6 (p<0.001). After risk adjustment, DM remained a risk factor for postoperative arrhythmias with an odds ratio of 1.63 (p=0.005), neurological complications with an odds ratio of 2.03 (p=0.007), pulmonary complications with an odds ratio of 1.96 (p<0.001), infectious complications with an odds ratio of 2.76 (p<0.001), and renal complications with an odds ratio of 2.78 (p<0.001). Conclusion: Diabetic and non-diabetic patients have similar in-hospital mortality rates. DM was an independent predictor for postoperative complications. Keywords: Diabetic mellitus; Cardiac surgery; Mortality; Postoperative complications