Influence of preoperative diabetes compensation on complications after cardiac surgery

Background: Diabetes mellitus is one of the most common civilization-related diseases of the 21st century It appears in nearly 1/3 of patients operated on in cardiac surgery departments Objectives: The aim of the study was to assess frequency of complications after cardiac surgery according to the level of preoperative diabetes compensation Material and methods: The study was conducted on 130 patients operated on from December 2008 to September 2009 Patients with HbA(1c) level higher than 7%, suffering from uncompensated diabetes, were included in the study group Patients with HbA(1c) level lower than 7% with compensated diabetes formed a control group Mortality and frequency of complications after cardiac operations in both groups were assessed and compared Results: Risk of perioperative mortality according to the Euro-SCORE scale was comparable in both groups (5 32% vs 5 66%) In the control group (68 pts, 52%) there were no deaths, cardiac events appeared in 16 pts (23 5%), cerebrovascular accidents in 6 pts (8 8%), renal failure in 9 pts (13 2%), respiratory insufficiency in 1 patient (1 5%), and no wound infection was noticed In the study group (62 patients, 48%) 3 deaths (4 8%) were noticed, cardiac events appeared in 24 pts (38.7%), cerebrovascular accidents in 11 pts (16 2%), renal failure in 8 pts (12 9%), respiratory insufficiency in 5 pts (8 1%) and wound infections were noted in 2 patients (3 2%) Conclusions: 1 Nearly half of patients with diabetes diagnosed preoperatively were operated on in uncompensated status. 2 Preoperative compensation of diabetes significantly reduces postoperative complications and mortality 3 Preoperative examination of HbA(1c) is a good predictor of postoperative complications after cardiac surgery