PUB - Publikationen an der Universität Bielefeld

Aims: In the last few years there has been increasing evidence that the respiratory function of diabetic patients is impaired in the course of their disease. The objective of this paper was to investigate whether diabetic patients are particularly at risk of pulmonary complications during the peri-operative stage of coronary bypass surgery. Methods: The data of 8 555 patients who had undergone coronary bypass operations in the years between 1996 and 2004 were analysed. Depending on their diagnosis on admission and their fasting plasma glucose levels (FPG), these patients were classified as "no diabetes" (FPG < 126 mg / dl), "undiagnosed diabetes" (FPG 126 mg / dl), "oral therapy diabetes" or as "insulin-treated diabetes". The three diabetic groups were compared with the non-diabetic group in terms of the pre-operative and postoperative characteristics. Results: Compared with the reintubation rate of non-diabetic patients (1.8%), the reintubation rate among undiagnosed diabetic patients (4.6%) and of the insulin-treated diabetic patients (4.5%) was significantly higher (p<0.01). The proportion of patients who required respiration for periods longer than one day was also significantly higher among the undiagnosed diabetic patients (9.9%) and the insulin-treated diabetic patients (8.6%) than among the non-diabetic patients (4.8%; p<0.01). The regression models show that unidentified diabetes and insulin-treated diabetes constitute independent risk factors for peri-operative pulmonary complications. Conclusions: Predominantly undiagnosed and insulin-treated diabetic patients have a higher risk of suffering pulmonary complications in the peri-operative course of coronary bypass operations. These results may be explained if one considers the lung as another target organ of the diabetic disease.