COMPARISON OF FACTORS ASSOCIATED WITH 30-DAY MORTALITY AFTER CORONARY-ARTERY BYPASS-GRAFTING IN PATIENTS WITH VERSUS WITHOUT DIABETES-MELLITUS

The purpose of this study was to identify factors associated with 30-d ay mortality after coronary artery bypass graft surgery (CABG) among d iabetic patients, and to compare them with risk factors among nondiabe tics. A subanalysis of a prospective national cohort study was perform ed which included patients who underwent CABG in 14 medical centers in Israel during 1994. Data including patient demographic and historical information, comorbidity, and cardiac catheterization results were co llected by trained nurses. Data were derived from direct patient inter views, charts, catheterization reports, surgical reports, and national vital records. Multivariate logistic regression analysis was used to identify factors associated with a 30-day mortality in diabetic and no ndiabetic patient populations, The results showed that crude mortality was 5.0% among diabetic patients (n = 1,034) and 2.5% among nondiabet ics (n = 3,350; p <0.001). The risk profile in diabetics was found to be worse. Multivariate logistic regression analysis identified female gender, 3-vessel disease, and left main disease as independent risk fa ctors for 30-day, post-CABG mortality unique to diabetic patients. Lef t ventricular dysfunction was found to effect a greater risk among dia betic patients, whereas chronic renal failure was associated with grea ter risk among nondiabetics. In conclusion, we found differences in pa tterns of risk factors for post-CABG mortality between diabetics and n ondiabetics. These findings may help physicians to identify patients a t high risk for CABG mortality. (C) 1998 by Excerpta Medica, Inc.