Impact of diabetic versus non‐diabetic patients undergoing coronary artery bypass graft surgery on postoperative wound complications: A meta‐analysis

Abstract

AbstractThe effect of diabetes mellitus (DM) on the incidence of postoperative wound complications in patients with coronary artery bypass grafting (CABG) is still unclear. Thus, we performed a meta‐analysis of CABG in DM patients to evaluate existing data from both prospective and historical cohorts. The objective of this trial was to assess the relevance and extent of the effect of diabetes on the outcome of previous CABG procedures. Data sources like Embase and Pubmed were found throughout the research, and the language was limited to English through manual search. The searches were performed up to August 2023. The data were extracted from the study of the inclusion/exclusion criteria, the features of the population, the statistical approach and the clinical results. A qualitative evaluation of the qualifying studies has been carried out. Out of the 1874 studies identified, 21 cohort studies were chosen for analysis. Meta‐analyses were performed in 258 454 patients (71 351 diabetic and 187 103 non‐diabetic). Twenty‐one studies on deep sternal wound infections in CABG patients showed a lower rate of deep sternal wound infections in non‐diabetes group compared with those with diabetes (OR, 2.13; 95% CI: 1.97, 2.31, p < 0.00001). And 16 studies of superficial wound infections in patients undergoing CABG were found to be associated with a lower rate of superficial injury (OR, 1.93; 95% CI: 1.53, 2.43, p < 0.00001) compared with those with diabetes; In five trials, perfusion time during CABG (MD, 2.31; 95% CI: −0.16, 4.79, p = 0.07) was observed, and there were no significant differences between diabetes and non‐diabetes. Currently, there is a higher risk for CABG in diabetes than in non‐diabetes patients with sternal infections and superficial injuries. Future randomized trials will concentrate on the treatment of such perioperatively related complications, which will lower the risk of postoperative wound infection in diabetes.