Can Higher Body Mass Index Patients Save Blood Following On-pump Coronary Artery Bypass Grafting?

  • Wenyuan Zhang Department of Anesthesiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Sheng, China
  • Shibiao Chen Department of Anesthesiology, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Sheng, China
  • Xiaojie Liu Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College. No.167 North Lishi Road, Xicheng District, Beijing, China
  • Lijuan Wang Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College. No.167 North Lishi Road, Xicheng District, Beijing, China
  • Sudena Wang Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College. No.167 North Lishi Road, Xicheng District, Beijing, China
  • Yang Yu Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College. No.167 North Lishi Road, Xicheng District, Beijing, China
  • Hushan AO Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, Fuwai Hospital, for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College. No.167 North Lishi Road, Xicheng District, Beijing, China
Keywords: Body Mass Index, Coronary Artery Bypass Grafting, Bleeding, Transfusion

Abstract

Background: The association of obesity with postoperative bleeding volume and transfusions after coronary artery bypass grafting (CABG) is not clear. We evaluated the effects of body mass index (BMI) on bleeding volume and transfusions in patients undergoing on-pump CABG.

Methods: We investigated 1,050 patients, aged 24 years to 83 years, who underwent isolated, primary CABG with cardiopulmonary bypass (CPB) at Fuwai Hospital, Chinese Academy of Medical Sciences, from September 2017 to July 2018. We recorded preoperative medical and laboratory coagulation parameters, intraoperative data, and postoperative bleeding volume for 24 hours following surgery. Primary endpoint was bleeding volume within 24 hours and transfusions after surgery. We analyzed the correlation between bleeding volume within 24 hours and transfusions after surgery and preoperative data with univariate and multivariate linear regression and logistic regression.

Results: Old age significantly increased postoperative transfusions (OR = 1.035 95% CI 1.013-1.058, P = .002), whereas higher BMI (OR = 0.897 95% CI 0.848-0.949,
P < .001) and higher hemoglobin (HGB) (OR = 0.966 95% CI 0.954-0.978, P < 0.001) decreased postoperative transfusions. And, BMI independently was correlated with bleeding volume after multivariate regression analysis
(B = -0.257, P < .001).

Conclusions: Our findings suggest higher BMI may reduce postoperative bleeding volume and transfusion rate, thus such patients may save blood products during on-pump CABG.

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Published
2019-08-28
How to Cite
Zhang, W., Chen, S., Liu, X., Wang, L., Wang, S., Yu, Y., & AO, H. (2019). Can Higher Body Mass Index Patients Save Blood Following On-pump Coronary Artery Bypass Grafting?. The Heart Surgery Forum, 22(5), E352-E356. https://doi.org/10.1532/hsf.2559
Section
Articles