Effects of body size on operative, intermediate, and long-term outcomes after coronary artery bypass operation

Schwann, Thomas A.; Habib, Robert H.; Zacharias, Anoar; Parenteau, Gary L.; Riordan, Christopher J.; Durham, Samuel J.; Engoren, Milo

doi:10.1016/s0003-4975(00)02038-5

Cited by 127 publications

(90 citation statements)

References 19 publications

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“…A previous study done by our group found that obesity is an independent preoperative risk factor for sternal wound complications after CABG [23]. This is in association with Lu et al and Schwann et al [24,15]. Schwann suggests that this higher risk of wound infections may be due to a decreased perfusion of adipose tissue and increased incidence of diabetes in obese patients [15].…”

Section: Morbiditysupporting

confidence: 65%

Influence of obesity on in-hospital and early mortality and morbidity after myocardial revascularization

Lindhout

Wouters

Noyez

2004

European Journal of Cardio-Thoracic Surgery

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Objective: Obese patients are thought to have an increased risk for complications in coronary artery bypass surgery. Several risk stratification systems do not identify obesity as a variable for risk adjustment. The aim of this study is to evaluate the in-hospital and early (one year) mortality and morbidity in obese and non-obese patients after a CABG in the UMC St Radboud. Methods: The data of 1130 patients undergoing a myocardial revascularization from January 2000 to August 2002 were analyzed. Obesity was measured by the body mass index (BMI). A BMI $ 30 kg/m 2 was defined as obese. We compared 206 obese patients with 924 non-obese patients. Uni-and multivariate analysis were used to analyze the results. The 1-year survival was analyzed using Kaplan -Meier methods. Results: There were no significant differences between obese and non-obese patients according to postoperative myocardial infarction, re-operation for bleeding, in-hospital mortality, renal complications, neurological complications, pulmonary complications, gastrointestinal complications, re-intubation, re-admission on intensive care, ventilation time, days on intensive care, days in hospital and late mortality. Only the incidence of postoperative wound infections was increased in obese patients, 8.3% in the obese versus 4.4% in the non-obese ðP ¼ 0:02Þ: Multivariate analysis identified obesity only as risk factor for postoperative for wound infections (P ¼ 0:04; odds ratio: 1.97). Conclusions: Obese patients do not have an increased risk of in-hospital and early (1 year) mortality after CABG. However, obese patients have an increased risk of postoperative wound infections compared to non-obese patients. q

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Section: Morbiditysupporting

confidence: 65%

Influence of obesity on in-hospital and early mortality and morbidity after myocardial revascularization

Lindhout

Wouters

Noyez

2004

European Journal of Cardio-Thoracic Surgery

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“…[3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Only one study, the largest study using the STS database, 3 found obesity to be significant for death, with ORs of 1.21 for BMI of 35 to 40 kg/m 2 and 1.58 for BMI Ͼ40 kg/m 2 . One other study 4 found it to be protective.…”

Section: Previous Studiesmentioning

confidence: 99%

“…Another study with a medium-sized sample 4 found high BMI to be protective, and 3 studies found "underweight" (very low BMI) to be a risk factor. [5][6][7] The remaining 12 studies did not find any effect of BMI. 8 -19 Motivated by these apparently contradictory findings, we used the Providence Health System Cardiovascular Study Group (PHS) database to investigate the role of BMI in CABG operative (in-hospital) mortality.…”

mentioning

confidence: 98%

Is Obesity a Risk Factor for Mortality in Coronary Artery Bypass Surgery?

et al. 2005

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for the Providence Health System Cardiovascular Study Group Background-The published articles examining obesity and CABG surgery contain conflicting results about the role of body mass index (BMI) as a risk factor for in-hospital mortality. Methods and Results-We studied 16 218 patients who underwent isolated CABG in the Providence Health System Cardiovascular Study Group database from 1997 to 2003. The effect of BMI on in-hospital mortality was assessed by logistic regression, with BMI group (underweight, normal, overweight, and 3 subgroups of obesity) as a categorical variable or transformations, including fractional polynomials, of BMI as a continuous variable. BMI was not a statistically significant risk factor for mortality in any of these assessments. However, using cumulative sum techniques, we found that the lowest risk-adjusted CABG in-hospital mortality was in the high-normal and that overweight BMI subgroup patients with lower or higher BMI had slightly increased mortality. Conclusions-Body size is not a significant risk factor for CABG mortality, but the lowest mortality is found in the high-normal and overweight subgroups compared with obese and underweight. (Circulation. 2005;111:3359-3365.)

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“…On the other hand, some authors believe that obesity is associated with mortality after CABG surgery. [5,26] Interestingly, there is another group of studies which supports a U-shaped pattern for mortality after CABG, [27,28] These authors indicated that extreme BMIs, in both very low and very high ranges, are associated with the increased rates of mortality after CABG.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have also reported that obese patients can develop sternal wound infections due to poor healing of the adipose chest wall tissue. [9,27,34] Furthermore, the operation time might also play a role in wound healing and subsequent infections.…”

Section: Discussionmentioning

confidence: 99%

Effects of body mass index on the early surgical outcomes after coronary artery bypass grafting

Bagheri¹

2014

Turk Gogus Kalp Dama

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Effects of body size on operative, intermediate, and long-term outcomes after coronary artery bypass operation

Cited by 127 publications

References 19 publications

Influence of obesity on in-hospital and early mortality and morbidity after myocardial revascularization

Influence of obesity on in-hospital and early mortality and morbidity after myocardial revascularization

Is Obesity a Risk Factor for Mortality in Coronary Artery Bypass Surgery?

Effects of body mass index on the early surgical outcomes after coronary artery bypass grafting

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