Influence Of Diabetes On Perioperative Complications And Prognosis Of Cardiac Surgery

Objective:To retrospectively analyze postoperative complications and clinical outcomes in diabetic and non-diabetic patients undergoing cardiac surgery.Methods:From January 2019 to February 2020,case data of 634 patients receiving cardiac surgery in the First Affiliated Hospital of Xinjiang Medical University were collected.They were divided,depending on their diagnosis,into diabetic and non-diabetic groups.After excluding missing data and lost follow-up,48 diabetic patients and 407 non-diabetic patients were finally included.A unified form was used to record preoperative general data of patients,and the incidence of postoperative ICU stay,mechanical ventilation time,total hospital stay,perioperative cardiovascular adverse events and other complications were collected.SPSS26.0 statistical software was used to match the general data lines of the diabetic group(n=48)and the non-diabetic group(n=407),and 46 patients in the post-diabetic group and 114 in the non-diabetic group were matched.The diabetic group was further divided into insulin group(n=26)and non-insulin group(n=20)according to the different treatment methods of blood glucose control.The postoperative clinical indicators of patients in each subgroup were compared to evaluate the influence of diabetes on postoperative complications and outcomes of patients undergoing cardiac surgery.Results: Postoperative mechanical ventilation time,ICU stay time and hospitalization days in diabetic patients were significantly increased compared with non-diabetic patients,with statistical significance(P < 0.05).The incidence of postoperative renal function injury and poor wound healing in diabetic patients was higher than that in non-diabetic patients,with statistical significance(P < 0.05).There was no statistical significance in the second operation,postoperative cardiovascular adverse events,and mortality within 30 days in 2 groups(P > 0.05).There was no statistical significance in preoperative general information,postoperative complications and outcome of insulin group and non-insulin group(P > 0.05).The 3-year survival rate was significantly lower in patients with diabetes than in patients without diabetes(21.7% vs9.6%,P=0.045).3 years postoperative mortality was similar between insulin group and non-insulin group(23.1% vs 20%,P=0.793).Conclusions: After matching and adjusting for multiple confounding factors,the risk of postoperative renal injury in diabetic patients undergoing surgery was 2.88 times that of non-diabetic patients,and the risk of postoperative poor wound healing was 2.83 times that of non-diabetic patients.Compared with non-diabetic patients,the postoperative mechanical ventilation time was 7.5h longer,the ICU stay time was 25.5h longer and the length of stay was 4d longer.The clinical outcome of diabetic patients was worse 3 years after surgery.Different ways of controlling blood glucose did not affect perioperative complications and clinical outcome of diabetic patients.