Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #107264

Elena A. Rucabado, MSc¹, Cynthia M. Pérez, PhD¹, José Escabí, MD², and Rodolfo Vargas, MS¹. (1) Department of Biostatistics and Epidemiology, University of Puerto Rico Graduate School of Public Health, PO Box 365067, San Juan, PR 00936-5067, 787-755-0199, elenarucabado@yahoo.com, (2) VA Medical Center of San Juan, Cardiology Section, Casia St. #10, San Juan, PR 00921-3201

Objectives: To determine the impact of diabetes and glycemia control in the development of 30-day coronary artery bypass grafting (CABG) complications in the veteran's population of Puerto Rico.

Background: Diabetes is an important determinant of morbidity and mortality during and after cardiac revascularization. However, the impact of diabetes and glycemia control after CABG has not been evaluated in Puerto Rico.

Methods: Perioperative characteristics and 30-day complications were gathered from all patients undergoing CABG at the Veterans Medical Center of San Juan between January 2001 and June 2003 (n=252). Primary outcomes were defined as major complications such as death and myocardial infarction; secondary outcomes included other less life-threatening complications such as infections and atrial tachyarrhythmias. Multiple logistic regression analysis was performed to estimate the adjusted incidence odds ratio (IOR) of CABG complications associated with diabetes and preoperative glucose levels.

Results: The study population comprised 141 (55.9%) patients with diabetes, of which, 12.8% had elevated preoperative glucose levels (≥200 mg/dl). Most frequent primary and secondary complications were myocardial infarction (4.8%) and heart failure (4.8%), and atrial fibrillation/flutter (26.9%) and infections (16.3%), respectively. Diabetes was significantly associated with primary complications (IOR: 1.12; IC 95%: 1.01-1.23), whereas elevated preoperative glucose was marginally associated with secondary complications (IOR: 1.25; IC 95%: 0.98-1.59).

Conclusions: Consistent with previous studies, patients with diabetes experienced a significant higher risk of 30-day CABG complications. This finding highlights the importance of a thorough assessment of patients with diabetes undergoing CABG in order to further reduce the risk of surgical complications.

Learning Objectives:

• Describe the most frequent 30-day CABG complications.
• Identify perioperative characteristics associated with 30-day CABG complications.
• Evaluate the association between DM and 30-day CABG complications after adjusting for potential cofounders.

Keywords: Diabetes, Epidemiology

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.