Sternal Dehiscence in Patients with Type 2 Diabetes Mellitus After Coronary Artery Bypass Grafting Using Bilateral Internal Mammary Arteris: A Systematic Literature Review and Meta-Analysis
Keywords:
sternal dehiscence, diabetes mellitus, coronary artery bypass graft, bilateral internal mammary artery, systematic literature review, meta-analysisAbstract
Background: Sternal dehiscence is a severe complication after coronary artery bypass grafting (CABG), especially in diabetic patients undergoing bilateral internal mammary artery graft (BIMA). This systematic review and meta-analysis aimed to evaluate the prevalence, risk factors, and outcomes associated with sternal dehiscence in this patient population.
Methods: A comprehensive search of electronic databases was performed to identify studies reporting sternal dehiscence in diabetic patients after CABG with BIMA. The primary outcomes assessed were the incidence from sternal dehiscence, risk factors, and associated morbidity and mortality. Data were combined by using meta-analysis where appropriate.
Results: Meta-analysis showed a prevalence of sternal dehiscence of 5% in diabetic patients, significantly higher than in non-diabetics (2%). Independent risk factors identified included age >65 years (OR 1.5), obesity (OR 1.8), and uncontrolled diabetes (OR 2.2). The most common complication is wound infection (about 70%), with a median length of stay of 5 days.
Conclusion: Sternal dehiscence is a significant complication in diabetic patients undergoing CABG with BIMA. Several risk factors have been identified, by the importance of targeted preventive strategies. Further research should focus on developing novel biomarkers to predict sternal dehiscence risk and evaluating the effectiveness of preventive interventions.
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