The effect of type II diabetes mellitus on early morbidity after mitral valve replacement for mitral valve disease

Yılmaz, Mustafa; Demircin, Metin; DOĞAN, Rıza; KUMBASAR, Ulaş; PAŞAOĞLU, İlhan

The effect of type II diabetes mellitus on early morbidity after mitral valve replacement for mitral valve disease

Ulaş KUMBASAR, (Ahi Evran Üniversitesi, Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Kırşehir, Türkiye)

Metin DEMİRCİN, (Hacettepe Üniversitesi, Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Ankara, Türkiye)

Rıza DOĞAN, (Hacettepe Üniversitesi, Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Ankara, Türkiye)

Mustafa YILMAZ, (Hacettepe Üniversitesi, Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Ankara, Türkiye)

İlhan PAŞAOĞLU (Hacettepe Üniversitesi, Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, Ankara, Türkiye)

Gazi Medical Journal

2 0

Yıl: 2011 Cilt: 22 Sayı: 4 Sayfa Aralığı: 105 - 109 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

The effect of type II diabetes mellitus on early morbidity after mitral valve replacement for mitral valve disease

Öz:

Amaç: Diyabetes mellitusun izole kalp kapağı operasyonları sonrası morbidite ve mortaliteye etkisi halen tam anlamıyla tanımlanamamıştır. Bizim çalışmamızın amacı da mitral kapak hastalığına bağlı izole mitral kapak replasmanı yapılan hastalarda diabetes mellitusun postoperatif erken morbidite üzerine olan etkisinin incelenmesidir. Yöntemler: 2000-2010 yılları arasında Hacettepe Üniversitesi Tıp Fakültesi Kalp ve Damar Cerrahisi Kliniğinde mitral kapak replasmanı yapılan 214 erişkin hasta retrospektif olarak incelenmiştir. DM tanısı olan 36 hasta grup Ii, DM tanısı olmayan 178 hasta da grup IIyi oluşturmuştur. Bulgular: Hastaların preoperatif özellikleri karşılaştırıldığında, serebrovasküler bozukluk, KOAH, aritmi ve renal fonksiyon bozukluğu açısından gruplar arasında farklılık saptanmadı. Ancak, preoperatif hipertansiyon öyküsü diabetik grupta istatistiksel olarak anlamlı olacak şekilde daha sık olarak görüldü. Preoperatif Ejeksiyon fraksiyon (EF) değeri de grup Ide grup IIye göre anlamlı biçimde düşük bulundu. Grup Ide postoperatif serebrovasküler bozukluk oranı, postoperatif entübasyon süresi, postoperatif yoğun bakımda ve hastanede kalış süresi, yara yeri enfeksiyonu oranı ve revizyon oranı istatistiksel olarak anlamlı düzeyde yüksek saptandı (sırasıyla p=0.015, p=0.01, p=0.01, p=0.023, p=0.003 ve p=0.045). Postoperatif aritmi oranı, postoperatif renal fonksiyon bozukluğu, KPB süresi, aort klemp süresi ve erken mortalite açısından gruplar arasında anlamlı farklılık görülmedi. Diabetin yara yeri enfeksiyonu oranını 5.9 kat (p=0.002), SVB oranını 5.6 kat (p=0.009), aritmi oranını 1.3 kat (p=0.497) ve revizyon oranını 3 kat (p=0.042) arttırdığı hesaplandı. Sonuç: Mitral kapak hastalığı nedeniyle MVR yapılan hastalarda DM birçok yönden risk faktörü oluşturarak erken dönem morbiditeyi olumsuz etkilemektedir. Kapak replasmanı planlanan ileri yaşlı ve ciddi risk profili içeren hastaların sayısının giderek arttığı da düşünüldüğünde DMnin bu etkisi cerrahi planlamada değerlendirmeye alınmalıdır. (Gazi Med J 2011; 22: 105-9)

Anahtar Kelime:

Konular: Anestezi Endokrinoloji ve Metabolizma Geriatri ve Gerontoloji Kalp ve Kalp Damar Sistemi

Mitral kapak hastalığı nedeniyle mitral kapak replasmanı yapılan hastalarda diyabetes mellitusun erken morbiditeye etkisi

Öz:

Objective: The impact of DM on post-operative morbidity and mortality after valve surgery is less well defined and the results of the studies are controversial. This study evaluated the effects of DM on post-operative short-term morbidity after isolated mitral valve replacement. Methods: The study population included 214 consecutive patients undergoing isolated mitral valve replacement (MVR) with mechanical valves under cardiopulmonary bypass (CPB). Patients were divided into two groups; diabetics (group I, n=36) and non-diabetics (group II, n=178). The groups were compared with respect to pre- and postoperative creatinine and blood urea nitrogen (BUN) levels, post-operative cerebrovascular disorders, arrhythmia, post-operative revision due to blood loss, surgical site infection, post-opertive extubation time, intensive care unit (ICU) and in-hospital stay time, CPB and aortic cross-clamp time. Results: In the diabetic group, post-operative rate of cerebrovascular disorders (13.9% vs. 2.8%; p=0.015), intubation time (11.5±7.6 h vs. 10.4±15.9 h; p=0.001), length of ICU stay (3.5±2.9 d vs. 2.7±2.1 d; p=0.001) and in-hospital stay (14.4±8.9 d vs. 11.1±6.9 d; p=0.023), rate of surgical site infection (19.4% vs. 3.9%; p=0.003), revision requirement rate (16.7% vs. 6.2%; p=0.045) were significantly higher. DM was also identified as an independent risk factor for surgical site infection, cerebrovascular disorder, arrhythmia and requirement of revision. Conclusion: This study showed that DM not only increases short-term morbidity due to its multiple effects but is also an independent risk factor for surgical site infection, cerebrovascular disorder, arrhythmia and requirement of revision after isolated mitral valve replacement procedures. (Gazi Med J 2011; 22: 105-9)

Anahtar Kelime:

Konular: Anestezi Endokrinoloji ve Metabolizma Geriatri ve Gerontoloji Kalp ve Kalp Damar Sistemi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	KUMBASAR U, Demircin M, DOĞAN R, Yılmaz M, PAŞAOĞLU İ (2011). The effect of type II diabetes mellitus on early morbidity after mitral valve replacement for mitral valve disease. , 105 - 109.
Chicago	KUMBASAR Ulaş,Demircin Metin,DOĞAN Rıza,Yılmaz Mustafa,PAŞAOĞLU İlhan The effect of type II diabetes mellitus on early morbidity after mitral valve replacement for mitral valve disease. (2011): 105 - 109.
MLA	KUMBASAR Ulaş,Demircin Metin,DOĞAN Rıza,Yılmaz Mustafa,PAŞAOĞLU İlhan The effect of type II diabetes mellitus on early morbidity after mitral valve replacement for mitral valve disease. , 2011, ss.105 - 109.
AMA	KUMBASAR U,Demircin M,DOĞAN R,Yılmaz M,PAŞAOĞLU İ The effect of type II diabetes mellitus on early morbidity after mitral valve replacement for mitral valve disease. . 2011; 105 - 109.
Vancouver	KUMBASAR U,Demircin M,DOĞAN R,Yılmaz M,PAŞAOĞLU İ The effect of type II diabetes mellitus on early morbidity after mitral valve replacement for mitral valve disease. . 2011; 105 - 109.
IEEE	KUMBASAR U,Demircin M,DOĞAN R,Yılmaz M,PAŞAOĞLU İ "The effect of type II diabetes mellitus on early morbidity after mitral valve replacement for mitral valve disease." , ss.105 - 109, 2011.
ISNAD	KUMBASAR, Ulaş vd. "The effect of type II diabetes mellitus on early morbidity after mitral valve replacement for mitral valve disease". (2011), 105-109.

APA	KUMBASAR U, Demircin M, DOĞAN R, Yılmaz M, PAŞAOĞLU İ (2011). The effect of type II diabetes mellitus on early morbidity after mitral valve replacement for mitral valve disease. Gazi Medical Journal, 22(4), 105 - 109.
Chicago	KUMBASAR Ulaş,Demircin Metin,DOĞAN Rıza,Yılmaz Mustafa,PAŞAOĞLU İlhan The effect of type II diabetes mellitus on early morbidity after mitral valve replacement for mitral valve disease. Gazi Medical Journal 22, no.4 (2011): 105 - 109.
MLA	KUMBASAR Ulaş,Demircin Metin,DOĞAN Rıza,Yılmaz Mustafa,PAŞAOĞLU İlhan The effect of type II diabetes mellitus on early morbidity after mitral valve replacement for mitral valve disease. Gazi Medical Journal, vol.22, no.4, 2011, ss.105 - 109.
AMA	KUMBASAR U,Demircin M,DOĞAN R,Yılmaz M,PAŞAOĞLU İ The effect of type II diabetes mellitus on early morbidity after mitral valve replacement for mitral valve disease. Gazi Medical Journal. 2011; 22(4): 105 - 109.
Vancouver	KUMBASAR U,Demircin M,DOĞAN R,Yılmaz M,PAŞAOĞLU İ The effect of type II diabetes mellitus on early morbidity after mitral valve replacement for mitral valve disease. Gazi Medical Journal. 2011; 22(4): 105 - 109.
IEEE	KUMBASAR U,Demircin M,DOĞAN R,Yılmaz M,PAŞAOĞLU İ "The effect of type II diabetes mellitus on early morbidity after mitral valve replacement for mitral valve disease." Gazi Medical Journal, 22, ss.105 - 109, 2011.
ISNAD	KUMBASAR, Ulaş vd. "The effect of type II diabetes mellitus on early morbidity after mitral valve replacement for mitral valve disease". Gazi Medical Journal 22/4 (2011), 105-109.