Effect of Body Mass Index on Mortality and Morbidity in Patients Undergoing Coronary Artery Bypass Grafting Surgery
DOI:
https://doi.org/10.1532/hsf.1458Abstract
Background: This study aims to investigate the effect of body mass index (BMI) on mortality and morbidity in patients undergoing coronary artery bypass grafting (CABG) surgery.Methods: We retrospectively evaluated the medical records of 403 patients undergoing coronary artery bypass surgery in our center. The patients were divided into 5 groups according to their BMI values. Preoperative demographic characteristics, operative data, and postoperative complications during the six-month follow-up period were compared between the groups.
Results: There were no statistically significant differences between the groups except the coexistence of peripheral artery disease (P = .009), ejection fraction (P = .021) and chronic obstructive pulmonary disease (P = .044). There were no statistically significant differences between the groups in terms of postoperative complications. No relationship was found between postoperative complications and the implemented surgical procedures. An overall 30-day mortality rate of 1.48% was observed, and the six-month mortality rate was 1.7%.
Conclusion: According to this study, obesity does not lead to an increased risk of mortality and other adverse outcomes after CABG surgery. However, obesity may prolong hospital stay and increase the cost of CABG operation.
References
Anderson RP. 1994. First publications from the Society of Thoracic Surgeons National Database. Ann Thoracic Surg 57:6-7.
Atalan N, Fazlioğulları O, Kunt AT, et al. 2012. Effect of body mass index on early morbidity and mortality after isolated coronary artery bypass graft surgery. J Cardiothorac Vasc Anesth 26:813-17.
Berchtold P, Jorgens V, Finke C, Berger M. 1981. Epidemiology of obesity and hypertension. Int J Obes 5:1-7.
Birkmeyer NJ, Charlesworth DC, Hernandez F, et al. 1998. Obesity and risk of adverse outcomes associated with coronary artery bypass surgery. Circulation 97:1689-94.
De Backer G, Ambrosioni E, Borch-Johnsen K, et al. 2003. European guidelines on cardiovascular disease prevention in clinical practice: third joint task force of European and other societies on cardiovascular disease prevention in clinical practice. Eur J Cardiovasc Prev Rehabil 10:10.
Fontaine KR, Redden DT, Wang C, et al. 2003. Years of life lost due to obesity. JAMA 289:187.
Fried LP, Tangen CM, Walston J, et al. 2008. Frailty in older adults: Evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56:146-56.
Garrow JS, Webster J. 1985. Quetelet’s index as a measure of fatness. Int J Obes 9:147.
Gruberg L, Mercado N, Milo S, et al. 2005. Impact of BMI on the outcome of patients with multi vessel disease randomized to either CABG or stenting in the ARTS trial: the obesity paradox? Am J Cardiol 95:439-44.
Hubert HB, Feinleib M, Mc Namara PM, Castelli WP. 1983. Obesity as an independent risk factor for cardiovascular disease: a 26 year follow up of participants in the Framingham Heart study. Circulation 67:968-77.
Lavie CJ, Ventura HO, Messerli FH. 1992. Left ventricular hypertrophy. Its relationship to obesity and hypertension. Postgrad Med 91:131-43.
Lavie CJ, Milani RV, Ventura HO. 2009. Obesity and cardiovascular disease risk factor, paradox, and impact of weight loss. J Am Coll Cardiol 53:1925-32.
Moulton M, Creswell L, Mackey ME, Cox JL, Rosenbloom M. 1996. Obesity is not a risk factor for significant adverse outcomes after cardiac surgery. Circulation 94:87-92.
Nalysnyk L, Fahrbach K, Reynolds MW, Zhao SZ, Ross S. 2003. Adverse events in coronary artery bypass graft trials: asystematic review and analysis. Heart 89:767-72.
Nashef SA, Roques F, Michel P, Gauducheau E, Lemeshow S, Salamon R. 1999. European system for cardiac operative risk evaluation (EuroSCORE). Eur J Cardiothorac Surg 16:9-13.
Oliveira B, Soares EF, Santos CA, et al. 2011. Risk factors for mediastinitis after coronary artery bypass grafting surgery. Rev Bras Cir Cardiovasc 26:27-35.
Oreopoulos A, Mc Alister FA, Zadeh KK, et al. 2009. The relationship between body mass index, treatment and mortality in patients with established coronary artery disease. Eur Heart J 30:2584-92.
Orgeas MG, Troch G, Azoulay E, et al. 2004. Body mass index. An additional prognostic factor in ICU patients. Intensive Care Med 30:437-43.
Orhan G, Biçer Y, Aka SA, et al. 2004. Coronary artery bypass graft operations can be performed safely in obese patients. Eur J Cardiothorac Surg 25:212-7.
Perrotta S, Nilsson F, Brandrup-Wognsen G, et al. 2007. Body mass index and outcome after coronary artery bypass surgery. J Cardiovasc Surg 48:239.
Potapov EV, Loebe M, Anker S, et al. 2003. Impact of body mass index on outcome in patients after coronary artery bypass grafting with and without valve surgery. Eur Heart J 24:1933-41.
Shirzad M, Karimi A, Armadi SH, et al. 2009. Effects of body mass index on early outcome of coronary artery bypass surgery. Minerva Chir 64:17-23.
Stamou SC, Nussbaum M, Stiegel RM, et al. 2011. Effect of body mass index on outcomes after cardiac surgery: is there an obesity paradox? Ann Thorac Surg 91:42.
Tüik. 2008. Death Statistics. ISBN 978-975-19-4660-7, 25.
World Health Organization. 2008. Global strategy on diet, physical activity, and health. Available at: http://whqlibdoc.who.int/publications/2009/9789241597418.html. Accessed October 10, 2012.
Youn YN, Kwak YL, Yoo KJ. 2007. Can the EuroSCORE predict the early and mid-term mortality after off-pump coronary artery bypass grafting? Ann Thorac Surg 83:2111–7.
