Prevalence of Diabetes Melitus, Glicemic Status in Periopeative Period and the Incidence of Complications in the Early Postoperative Period in Patients Operated for Heart Disease

Introduction: Patients with diabetes who require surgical intervention are at increased risk of numerous complications. Complications arise due to already developed vasculopathy and neuropathy, but surgery in itself represents stress for the body and causes reactive hyperglycemia, which can affect the development of complications just as in patients with diagnosed diabetes mellitus.

Methods: Retrospective analysis of prospectively recorded electronic records of 130 patients who had myocardial revascularization and/or replacement of heart valves with the use of extracorporeal circulation at the Department of Cardiac and Transplant Surgery of the University Hospital Dubrava.

Results: The prevalence of diabetes in the population of patients who underwent heart surgery was 31%. Out of a total of 130 patients 34% of them developed some complications in the postoperative period. These were delirium (3% of patients), cerebrovascular stroke (0.7% of patients), urinary tract infections (8.4% of patients), superficial and deep sternum infections (4% of patients), atrial fibrillation (12% of patients), pneumonia (1.5% of patients), prolonged mechanical ventilation (0.7% of patients) and death within 30 days of surgery (3% of patients). Complications occurred equally in diabetics as in patients who were not diagnosed with diabetes.
The obvious difference in the occurrence of complications between the diabetic and non-diabetic groups was the number of patients that developed delirium, which occurred in a total of 3% of patients, in the diabetic group in 7% of patients and in the non-diabetic group in 1% of patients. In diabetics, delirium occurred 6.94 times more often than in patients who had not been diagnosed with diabetes.

Conclusion: There is no strong evidence that diabetes has an impact on the occurrence of complications after heart surgery, except for the occurrence of delirium which is much more common in the diabetic group.

Keywords: Dementia, Depression, Anxiety, Affective Disorder, Wheelchair, Ambulatory.