Effect of Obesity on Early Morbidity and Mortality Following Cardiac Surgery

Yap, Cheng‐Hon; Zimmet, Adam; Mohajeri, Morteza; Yii, Michael

doi:10.1016/j.hlc.2006.09.007

Cited by 38 publications

(38 citation statements)

References 17 publications

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“…Fifty‐six studies examined incidence of post‐surgical infections and complications in patients who were obese, compared with those who were normal weight. Fifty‐four of the studies reported increased complications associated with obesity . Thirteen of 56 of the studies reported higher incidence of infection, 20 of the 56 found an increase in surgical site infections, six of the studies found higher degrees of deep sternal wound infections and 14 studies reported other types of post‐operative complications such as re‐hospitalization.…”

Section: Resultsmentioning

confidence: 99%

Interaction of obesity and infections

2015

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There is evidence that certain infections may induce obesity. Obese persons may also have more severe infections and have compromised response to therapies. The objective of this study is to review the available literature identifying infections that potentially contribute to greater body mass index (BMI) and differential responses of overweight and obese persons to infections. A systematic literature review of human studies examining associations between infections and weight gain, differential susceptibility, severity, and response to prevention and treatment of infection according to BMI status (January 1980-July 2014) was conducted. Three hundred and forty-three studies were eligible for inclusion. Evidence indicated that viral infection by human adenovirus Ad36 and antibiotic eradication of Helicobacter pylori were followed by weight gain. People who were overweight or obese had higher susceptibility to developing post-surgical infections, H1N1 influenza and periodontal disease. More severe infections tended to be present in people with a larger BMI. People with a higher BMI had a reduced response to vaccinations and antimicrobial drugs. Higher doses of antibiotics were more effective in obese patients. Infections may influence BMI, and BMI status may influence response to certain infections, as well as to preventive and treatment measures. These observations have potential clinical implications.

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Section: Resultsmentioning

confidence: 99%

Interaction of obesity and infections

2015

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“…There were seven retrospective cohort studies [11,15-18,25,26] and fifteen prospective cohort studies [8-10,12-14,19-24,27,28,35]. The durations of follow-up varied from 1 year to 15.8 years.…”

Section: Resultsmentioning

confidence: 99%

Obesity survival paradox in pneumonia: a meta-analysis

Nie

Zhang²,

Jee

et al. 2014

BMC Med

179

139

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BackgroundIt is unclear whether an ‘obesity survival paradox’ exists for pneumonia. Therefore, we conducted a meta-analysis to assess the associations between increased body mass index (BMI), pneumonia risk, and mortality risk.MethodsCohort studies were identified from the PubMed and Embase databases. Summary relative risks (RRs) with their corresponding 95% confidence intervals (CIs) were calculated using a random effects model.ResultsThirteen cohort studies on pneumonia risk (n = 1,536,623), and ten cohort studies on mortality (n = 1,375,482) were included. Overweight and obese individuals were significantly associated with an increased risk of pneumonia (RR = 1.33, 95% CI 1.04 to 1.71, P = 0.02, I2 = 87%). In the dose–response analysis, the estimated summary RR of pneumonia per 5 kg/m2 increase in BMI was 1.04 (95% CI 1.01 to 1.07, P = 0.01, I2 = 84%). Inversely, overweight and obese subjects were significantly associated with reduced risk of pneumonia mortality (RR = 0.83, 95% CI 0.77 to 0.91, P < 0.01, I2 = 34%). The estimated summary RR of mortality per 5 kg/m2 increase in BMI was 0.95 (95% CI 0.93 to 0.98, P < 0.01, I2 = 77%).ConclusionsThis meta-analysis suggests that an ‘obesity survival paradox’ exists for pneumonia. Because this meta-analysis is based on observational studies, more studies are required to confirm the results.

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“…However, the relationship between BMI and its effect on postoperative CABG is controversial: some studies found no significance between high BMI and mortality [13][14][15][16]; others have shown a positive correlation between obesity and postoperative complications [17][18][19]. Gurm et al [20] found a short-term protective effect of obesity in patients who had undergone CABG.…”

Section: Introductionmentioning

confidence: 99%

O efeito do índice de massa corporal sobre as complicações no pós-operatório de cirurgia de revascularização do miocárdio em idosos

Reis

Barbiero²,

Ribas³

2008

Rev Bras Cir Cardiovasc

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O efeito do índice de massa corporal sobre as complicações no pós-operatório de cirurgia de revascularização do miocárdio em idososThe effect of the body mass index on postoperative complications of coronary artery bypass grafting in elderly Abstract Objectives: To evaluate the effect of BMI (body mass index) in the postoperative period of elderly patients undergoing CABG.Methods: Cross-sectional retrospective study, carried out in academic hospital, with all patients (n=290), aged or above 60 years, undergone CABG, from August 2006 to July 2007. The patients were divided into tertiles of BMI (<22, 22-27,> 27kg /m²). The variables included in the study were collected from medical records of patients and analyzed by logistic regression in association with the categories of BMI.Results: In the group with malnutrition were found larger percentage of impaired lung, kidney, hospital stay and immediate surgical mortality; but without statistical significance. Among female patients, the group malnutrition and eutrophy, 61.5% had hospital stay for a period longer than seven postoperative days compared to 42.5% male patients (p=0.003). In the group with malnutrition was found association between the CPB time and renal dysfunction with p<0.001 and, in eutrophic group with p=0.04. Obesity obtained protective association for lung dysfunction (RR=0.99), readmissions (RR=0.45) and mortality (RR = 0.77), and risk factor for renal dysfunction (RR=1.12). Conclusions 525REIS, C ET AL -The effect of the body mass index on postoperative complications of coronary artery bypass grafting in elderly Bras Cir Cardiovasc 2008; 23(4): 524-529 Rev

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Effect of Obesity on Early Morbidity and Mortality Following Cardiac Surgery

Cited by 38 publications

References 17 publications

Interaction of obesity and infections

Interaction of obesity and infections

Obesity survival paradox in pneumonia: a meta-analysis

O efeito do índice de massa corporal sobre as complicações no pós-operatório de cirurgia de revascularização do miocárdio em idosos

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