Preoperative Hba1c level in prediction of short-term morbidity and mortality outcomes following coronary artery bypass grafting surgery

Abstract

Objective ― This study was conducted to determine whether HbA1c is a predictor of short term mortality and morbidity after coronary artery bypass graft operation. Methods ― The coronary artery bypass graft operation was performed on the patients between January 2009 and January 2013. Each patient's medical record was retrospectively reviewed. The patients who were included in the study were evaluated in groups of 60. One group was comprised of nondiabetic patients, whose HbA1c level is below 6% (the control group 0), the other included diabetic patients with the HbA1c level is between 6-6.9% (the group 1) and the last group, group 2, included those patients with HbA1c level is equal or greater than 7%. Pre, peri and post operation data was compared. The deaths that occured in the first 30 days were evaluated as mortality and complications as morbitity. Results ― While mortality was not observed in the control group, one incident was observed in group 1 and 5 in group 2, which corresponds to 1.7% and 8.3% respectively. The mortality ratio in the group with patients whose HbA1c was greater or equal to 7% found statistically significant compared to the control group (P=0.02). The following parameters were observed in group 2 and were found statistically significant: the need for dialisis (25%, P<0.01), atrial fibrillation (33%, P=0.01), revision due to bleeding (10%, P=0.18), cerebrovascular event (16,7%, P=0.01), duration of mechanic ventilation (19.5±21.6, P=0.06), duration of hospital stay (approximately 9.91±5.35 days, P=0.01), infection in scar (53%, P<0.01), mediastenit (11%, P=0.01) and urinary tract infection (10%, P=0.01) Conclusion ― We concluded that in those diabetic patients that elective coronart artery bypass graft is applied, highly reactive HbA1c levels (HbA1c ≥7), may indicate morbitity in the early stages of post operation.