The aim of this study was to improve quality of life (QoL) and prognosis of patients with diabetes by identifying adverse factors, which will enable to set preventive measures.

Specific aims are:

1.To explore predictors for immediate as well as 1 to 1.5-year and 3-year mortality following coronary artery bypass grafting (CABG) surgery of patients with and without diabetes. 2. Compare post surgery outcomes i.e. re-hospitalization rates, healthcare utilization, return to work, QoL, level of depression and anxiety, physical fitness in cardiac patients with and without diabetes.

Working hypothesis:

 Patients with diabetes would have worse short and long term outcomes compared to non-diabetics undergoing CABG surgery.

Background:

Diabetes is a significant risk factor for adverse outcomes after CABG. The present study was an ancillary study of a multi-center study of 1027 persons scheduled for CABG surgery between January 2004 and November 2006. As many as 43% of our sample have diabetes and showed poorer baseline measures such as higher systolic blood pressure and body mass index, lower physical fitness, greater levels of anxiety and depression.

Methods:

Case-control longitudinal observational study of 1027 CABG patients from 5 cardio-thoracic wards. Pre-surgical evaluation included demographics, medical status, functional capacity and physical fitness, lifestyle habits, employment status, anthropometric measurements, QoL and psychological well-being parameters. Clinical information was extracted from medical charts regarding laboratory examinations, severity of coronary heart disease (CHD), length of hospital stay, and surgical procedures (use of pump, # of grafts). Within the present study we re-evaluated these patients through personal home-interviews, conducted at 12-18 months after CABG surgery, to collect the same information as in the baseline interview, with an emphasis on changes in indices during the follow up period.

Results:

 More than 40% of patients undergoing CABG in Israel have diabetes. While early and late post-operative mortality rates are similar, quality of life and mental state are worse among those with diabetes. Post-CABG patients with diabetes made greater use of medical services, and returned less to the workforce.

Conclusions:

The mental health and psychological state of individuals undergoing CABG, particularly those with diabetes, should be addressed.

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