Effect of Body Mass Index on Early Morbidity and Mortality After Isolated Coronary Artery Bypass Graft Surgery

Atalan, Nazan; Fazlioğulları, Osman; Kunt, Atike Tekeli; Başaran, Cem; Gürer, Onur; Sitilci, Tolga; Akgün, Serdar; Arsan, Sinan

doi:10.1053/j.jvca.2012.01.033

Cited by 21 publications

(24 citation statements)

References 26 publications

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“…Atalan et al (25) reported a similar retrospective observational study in 2012 and stated the results of 803 patients. They found a remarkable mortality rate in underweight group as 20%.…”

Section: Discussionmentioning

confidence: 89%

“…It is well-known that obesity is a risk factor for diabetes, high blood pressure, sleep apnea and other medical conditions that may contribute to heart problems. Recent studies have now shown that obese patients fair better after open heart surgery (23)(24)(25). This is called the obesity paradox and it continues to surprise physicians and scientists.…”

Section: Discussionmentioning

confidence: 99%

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Obesity is still a risk factor in coronary artery bypass surgery

Gürbüz¹,

Durukan²,

Salman³

et al. 2014

Anadolu Kardiyol Derg

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Objective: Even with the improvements in surgical techniques and perioperative care, obesity is still a risk factor for occurrence of adverse events following cardiac surgery. In this observational, retrospective study, we aimed to document the effects of obesity on surgical outcomes in patients undergoing coronary artery bypass surgery and find out the effects of improvements in cardiac surgery. Methods: Between January 2011 and March 2013, isolated coronary artery bypass surgery was performed on 790 patients. The body mass index values of the patients were calculated and patients were divided into two groups; below 30 were classified as non-obese group whereas above 30 were classified as obese group. The odds ratio was obtained by using univariate analysis in order to document the effects of obesity on outcomes.Results: There were 548 (69.3%) patients in non-obese group, whereas 242 (30.7%) patients in obese group. The cardiopulmonary bypass (80.47±23.58 vs. 80.89±28.46, p=0.449) and aortic clamp times (54.13±16.60 vs. 54.19±19.85, p=0.511) and number of bypass grafts (3.09±1.02 vs. 2.96±1.00, p=0.11) were comparable between the groups. The mean number of fresh frozen plasma used was higher in obese patients (1.37±1.75 vs. 1.48±4.63, p=0.02). Intubation time was higher in obese patients (10.57±6.87 vs. 12.71±35.31, p=0.014). Total amount of postoperative drainage was higher in non-obese patients (766.77±472.27 vs. 648.72±371.39, p<0.001). The superficial infection/mediastenitis (0.4% vs. 2.5%, p=0.012), dehiscence (0.2% vs. 3.7%, p<0.001) and postoperative renal failure rates (4.7% vs. 8.7%, p=0.031) were higher in obese patients. The incidence of atrial fibrillation was lower in obese patients (19.7% vs. 12.8%, p=0.019). The mortality (0.5% vs. 1.7%, p=0.210) and postoperative stroke rates (1.1% vs. 0.8%, p=1.000) were similar in both groups. Conclusion: We documented that obesity is still a risk factor for occurrence of postoperative adverse events. We believe that improved perioperative care together with meticulous regimens can improve postoperative outcomes in patients undergoing coronary artery bypass surgery.

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“…Atalan et al (25) reported a similar retrospective observational study in 2012 and stated the results of 803 patients. They found a remarkable mortality rate in underweight group as 20%.…”

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Obesity is still a risk factor in coronary artery bypass surgery

Gürbüz¹,

Durukan²,

Salman³

et al. 2014

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

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“…A higher incidence of wound problems and deep SSI was also observed postoperatively [11]. There is an established association between low BMI and poor surgical outcomes in a variety of disciplines [10], [11], [12], [23], [24], [25], [26], [27], [28], [29], [30]. Higher transfusion rates were observed among UW patients after surgical intervention following hip fracture repair and general surgery patients [10], [11].…”

Section: Discussionmentioning

confidence: 85%

“…These findings are similar to studies in the general surgery literature that have found that UW patients have greater complications than other patients. UW patients undergoing coronary artery bypass graft surgery have been found to have longer intensive care unit stays and longer LOS compared with NW patients [12]. UW minority patients evaluated through the American College of Surgeons’ National Surgical Quality Improvement Program Participant Use Data File exhibited higher mortality and postoperative complications than overweight and NW patients.…”

Section: Discussionmentioning

confidence: 99%

“…In the field of general surgery, UW patients (BMI < 18.5 kg/m 2 ) have a higher risk of mortality, morbidity, and poorer outcomes compared to overweight and obese patients [10], [11], [12], [13]. With regard to total joint arthroplasty, UW total hip arthroplasty (THA) patients have been identified as having a higher incidence of infection, transfusion, dislocation, readmission, and mortality [2], [3], [4], [14], [15].…”

Section: Introductionmentioning

confidence: 99%

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Surgical site infection and transfusion rates are higher in underweight total knee arthroplasty patients

et al. 2017

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BackgroundUnderweight (UW) patients undergoing total hip arthroplasty have exhibited higher complication rates, including infection and transfusion. No study to our knowledge has evaluated UW total knee arthroplasty (TKA) patients. We, therefore, conducted a study to investigate if these patients are at increased risk for complications, including infection and transfusion.MethodsA case-control study was conducted using a prospectively collected institutional database. Twenty-seven TKA patients were identified as UW (body mass index [BMI] < 18.5 kg/m2) from 2000-2012 and were matched for age, gender, date of surgery, age-adjusted Charlson comorbidity index, rheumatoid arthritis, and diabetes. These patients were compared to 81 normal weight patients (BMI 18.5-24 kg/m2). Demographic variables were compared, along with wound complications, surgical site infection (SSI), blistering, deep vein thrombosis, pulmonary embolism, transfusion, revision, flexion contracture, hematoma formation, and patellar clunk.ResultsThe average BMI was 17.1 kg/m2 (range 12.8-18.4) for UW and 23.0 kg/m2 (range 19.0-25.0) for normal weight patients (P < .001). UW TKA patients were more likely to develop SSIs (3/27, 11.1% vs 0/81, 0.0%, P = .01) and were more likely to require transfusions (odds ratio = 3.4, confidence interval 1.3-9.1; P = .02).ConclusionsOur study demonstrates that UW TKA patients have a higher likelihood of developing SSI and requiring blood transfusions. The specific reasons are unclear, but we conjecture that it may be related to decreased wound healing capabilities and low preoperative hemoglobin. Investigation of local tissue coverage and hematologic status may be beneficial in this patient population to prevent SSI. Based on the results of this study, a prospective evaluation of these factors should be undertaken.

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