Does diabetes mellitus increase immediate surgical risk in octogenarian patients submitted to coronary artery bypass graft surgery?

Júnior, Fernando Pivatto; Pereira, Edemar; Valle, Felipe Homem; Filho, Guaracy F Teixeira; Nesralla, Ivo A.; Sant'Anna, João Ricardo M; Prates, Paulo R.; Kalil, Renato A. K.

doi:10.5935/1678-9741.20120102

Cited by 4 publications

(3 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…On account of the CPB-induced damage, up to 10% of patients require prolonged postoperative care [ 3 ], with a more extended intensive care unit length of stay (ICU LOS) and mechanical ventilation duration (MVD) [ 4 ]. Recently, ICU-acquired weakness is evolving into a complication that cannot be neglected [ 5 ], and It is estimated that the ICU consumes 20%of hospital expenditures and approximately 1%of gross domestic product[ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

The effect of Ulinastatin on postoperative course in cardiopulmonary bypass patients in Asia: a meta-analysis of randomized controlled trials

Qiaoli

Chen

et al. 2022

J Cardiothorac Surg

View full text Add to dashboard Cite

Objectives To evaluate the effect of urinary trypsin inhibitor (UTI) or Ulinastatin on postoperative course and clinical outcomes in patients with cardiopulmonary bypass. Methods We searched PubMed, Embase, Web of Science, and Cochrane Library for the keywords UTI and Cardiopulmonary bypass (CPB). The primary outcome measure was the intensive care unit length of stay (ICU LOS), and results were stratified for relevant subgroups (dosage of UTI). The effects of UTI on mechanical ventilation duration (MVD), hospital LOS, renal failure incidence (RFI), and all-cause mortality were studied as secondary outcomes. Results Twelve randomized controlled trials (enrolling 1620 patients) were evaluated. Eleven studies pooled for subgroup analysis showed that using UTI persistently or with a considerable amount would lead to a shorter ICU LOS (95% CI, − 0.69 to − 0.06; P = 0.0001). Ten studies showed that UTI could shorten MVD in patients (95% CI, − 1.505 to − 0.473; P < 0.0001). RFI generally showed a more favourable outcome with UTI treatment (95%CI, 0.18–1.17; P = 0.10). And the current evidence was insufficient to prove that UTI could reduce the hospital LOS (95% CI, − 0.22 to 0.16; P = 0.75) and the all-cause mortality rate (95% CI, 0.24–2.30; P = 0.60). Conclusions Various subsets of UTI treatment suggested that UTI could shorten ICU LOS, and it is associated with the dosage of UTI. Considering the substantial heterogeneity and lack of criteria for UTI dosage, more evidence is needed to establish a standard dosing guideline.

show abstract

Section: Introductionmentioning

confidence: 99%

The effect of Ulinastatin on postoperative course in cardiopulmonary bypass patients in Asia: a meta-analysis of randomized controlled trials

Qiaoli

Chen

et al. 2022

J Cardiothorac Surg

View full text Add to dashboard Cite

show abstract

“…In Brazil, a study shows mortality as high as 11.8% in diabetic patients [ 10 ] . But another one with octogenarian patients did not found differences in mortality [ 11 ] .…”

Section: Introductionmentioning

confidence: 99%

Prognosis and Complications of Diabetic Patients Undergoing Isolated Coronary Artery Bypass Surgery

Santos¹,

Berto²,

Sousa³

et al. 2015

Brazilian Journal of Cardiovascular Surgery

View full text Add to dashboard Cite

Objective:Compare the prognosis and complications of diabetic and non-diabetic patients undergoing isolated coronary artery bypass surgery at a hospital with a high surgical volume.Methods:Data of patients who underwent coronary artery bypass surgery from June 2009 to July 2010 were analyzed. We selected diabetic and non-diabetic patients and evaluated their postoperative and long-term prognosis based on clinical complications. To reduce the disparity within the sample, statistical analyses were performed using propensity scores.Results:We included 2,688 patients who underwent coronary artery bypass surgery; 36% of them had diabetes, their mean age was 62.1±9.49 years and 70% (1,884) of them were men. Patients with diabetes were older (63±9 years vs. 61±10 years; P<0.001), more often obese (BMI>25 kg/m2: 70.7% vs. 64.5%; P<0.001), dyslipidemic (50.4% vs. 41.1%; P<0.001), hypertensive (89.2% vs. 78.7%; P<0.001), and presented chronic renal failure (8.3% vs. 3.8%; P<0.001). They also presented higher rates of acute renal failure (5.6% vs. 2.7%, P<0.001), infection (11.4% vs. 7.2%, P<0.001) and mortality after one year (9.1% vs. 5.6%, P<0.001). Pneumonia was more common among patients with diabetes (7.7% vs. 4.0%, P<0.001). According to propensity scoring, 430 patients (215 diabetics and 215 non-diabetics) had a mean age of 61.3±8.97 years, and 21.2% (91 of 430) were women. However, diabetes was not an independent factor for poor prognosis.Conclusion:Patients with diabetes were at higher risk for postoperative complications and mortality after undergoing coronary artery bypass surgery. However, diabetes did not explain the poor prognosis of these patients after pairing this factor with the propensity score.

show abstract

“…В схожем по дизайну исследовании наличие диабета не повышало риск сердечно-сосудистых ослож-нений и смертности, так же, как и других госпитальных осложнений КШ, за исключением почечной дисфунк-ции [49]. Не отмечено влияния СД на непосредствен-ные результаты КШ и среди 80-летних пациентов [50]. Тем не менее, даже в краткосрочной перспективе наличие СД приводило к существенному увеличению стоимости операции КШ (p<0,001), эта же тенденция сохранялась и через 2 года после операции (p<0,001) [33].…”

Section: влияние сд на непосредственные и отдаленные результаты коронunclassified

Myocardial revascularization in patients with coronary heart disease and type 2 diabetes

Безденежных

Sumin

2016

Diabetes mellitus

View full text Add to dashboard Cite

The review discusses myocardial revascularization in patients with coronary heart disease and type 2 diabetes. The data presented include findings from recent research and international and national recommendations and provides evidence on the advantages of coronary artery bypass surgery over percutaneous coronary intervention for patients with diabetes mellitus, stable coronary artery disease and multiple coronary artery lesions. Type 2 diabetes remains a significant predictor of adverse long-term outcomes of coronary artery bypass surgery. Therefore, we review studies showing that different strategies of coronary revascularization and preoperative preparation can affect the results of coronary intervention in patients with diabetes.

show abstract

Does diabetes mellitus increase immediate surgical risk in octogenarian patients submitted to coronary artery bypass graft surgery?

Cited by 4 publications

References 28 publications

The effect of Ulinastatin on postoperative course in cardiopulmonary bypass patients in Asia: a meta-analysis of randomized controlled trials

The effect of Ulinastatin on postoperative course in cardiopulmonary bypass patients in Asia: a meta-analysis of randomized controlled trials

Prognosis and Complications of Diabetic Patients Undergoing Isolated Coronary Artery Bypass Surgery

Myocardial revascularization in patients with coronary heart disease and type 2 diabetes

Contact Info

Product

Resources

About