The impact of metabolic syndrome on morbidity in patients undergoing Coronary Artery Bypass Graft (CABG) surgery.

Abstract

Objective: To compare the post-operative morbidity in patients undergoing coronary artery bypass graft surgery with versus without metabolic syndrome. Study Design: This study was a quasi-experimental study. Setting: Department of Cardiac Surgery, Faisalabad Institute of Cardiology Faisalabad. Period: 30/03/2022 to 29/03/2023 (12 month study). Methods: The present study involved 200 both male and female patients aged 30-65 years undergoing coronary artery bypass grafting assimilated into two equal groups containing 100 cases for each group i.e. with and without metabolic syndrome. Standard departmental protocols were adopted to manage these cases. Outcome variables were mean intubation time, mean ICU and hospital stay duration, as well as post-operative atrial fibrillation, respiratory complications and wound infection which were noted and compared between the groups. Results: The average age of the study participants was 51.4 ± 9.4 years, with a male predominance of 7:1. Among them, 60.5% had hypertension, and 35.5% were diagnosed with diabetes. When comparing outcomes between groups, patients with metabolic syndrome experienced significantly longer intubation times (21.35 ± 2.70 vs. 16.35 ± 1.70 hours; p=0.001), prolonged ICU stays (63.85 ± 7.81 vs. 50.38 ± 4.38 hours; p=0.001), and extended hospital stays (9.70 ± 1.92 vs. 7.17 ± 1.78 days; p=0.001) compared to those without it. Additionally, the incidence of postoperative atrial fibrillation (19.0% vs. 2.0%; p=0.001), respiratory complications (16.0% vs. 0.0%; p=0.001), and wound infections (20.0% vs. 3.0%; p=0.001) was remarkably higher among CABG recipients diagnosed with metabolic syndrome. Conclusion: Among patients undergoing CABG, the presence of metabolic syndrome was linked to increased post-operative morbidity, including prolonged intubation time, extended ICU and hospital stays, and a higher risk of atrial fibrillation, respiratory complications, and wound infections, irrespective of age, gender, and diabetic status. This underscores the need for routine metabolic syndrome screening in CABG candidates to enable early detection and proactive management, ultimately improving patient outcomes.