Diabetic and Non-Diabetic Patients Undergoing Coronary Revascularization

Hematological abnormalities associated with the diabetic state include reduced platelet function, enhanced factor activation and hyperfibrinolysis. The present investigation evaluated blood loss and the transfusion requirements in diabetic and non-diabetic patients undergoing extracorporeal circulation and cardiac surgery. A retrospective study of 151 consecutive patients undergoing primary coronary revascularization were classified into one of three groups based on their diabetic disease state: Insulin Dependent Diabetics (IDDM, n=5), Non-Insulin Dependent Diabetics (NIDDM, n=33), and Non-Diabetics (NDM, n=113). IDDM patients were significantly younger than either NIDDM or NDM patients, were 80% female, and had lower preoperative red cell mass. The IDDM group had a greater red blood cell transfusion volume (1650 ± 1485 ml) than NIDDM (958 ± 593 ml) and NDM (997 ± 827 ml) patients (p=0.21). There were no significant differences in homologous blood exposure or chest tube drainage in any group. Mean length of hospital stay (days) in the IDDM group (19.8 ± 18.3) was significantly greater than the NIDDM (9.9 ± 3.7), and the NDM (10.8 ± 5.8) patients (p<O.OOI). In conclusion, diabetic patients do not appear to be at increased risk for developing postcardiotomy coagulopathies, despite having greater morbidity, which results in increased hospital stay.