Effects of body mass index on early outcome of coronary artery bypass surgery.
ABSTRACT Obesity is commonly thought to be a risk factor for morbidity and mortality after cardiac surgery. The aim of the present study is to evaluate the effects of variations in body mass index on in-hospital outcome of coronary artery bypass grafting (CABG).
The authors conducted a retrospective review of 10191 consecutive patients who had undergone isolated CABG at the center from February 2002 to November 2006. Patients were divided into four groups according to Body Mass Index (BMI). Underweight patients (BMI<18.5 kg/m(2)) were assigned to group 1 and obese patients (BMI 30 kg/m(2)) were put into group 4. Patients with normal BMI and those who were overweight were placed in group 2 and 3 respectively.
Analysis of the BMI groups showed: of 10191 patients 0.7% was underweight; 31.2% of cases had normal BMI, 47.1%; overweight and 21.0% were obese. Compared with other groups, the members of the obese group were younger, included more women and were more likely to have all the risk factors for coronary artery disease except for cigarette smoking (P<0.0001). The underweight patients had an excess of left main coronary artery disease, previous history of myocardial infarction. In-hospital mortality did not show any difference between groups (P=0.46). There was a significant increase in postoperative gastrointestinal complications among the underweight group in comparison with other groups (P=0.027).
According to this study, obese patients undergoing CABG are not at a greater risk of perioperative death and other adverse outcomes compared to normal weight. After CABG, underweight patients are at higher risk of developing gastrointestinal complications compared to normal patients.
- Clinical nutrition (Edinburgh, Scotland) 08/2009; 28(5):481-3. DOI:10.1016/j.clnu.2009.06.010 · 3.94 Impact Factor
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ABSTRACT: Obesity is a well-known risk factor for coronary artery disease. The objective of our study was to examine the impact of obesity on long-term survival after coronary artery bypass grafting (CABG). Using prospectively gathered data, we reviewed records of 1163 consecutive patients who underwent isolated primary CABG between 1997 and 2007. We compared outcomes of obese patients (body mass index [BMI] > or = 30 kg/m(2); n = 472) and non-obese patients (BMI < 30 kg/m(2); n = 691). Long-term survival was assessed by using Kaplan-Meier curves generated by log-rank tests and adjusted for confounding factors with Cox logistic regression analysis. Obese patients were slightly younger (60 +/- 8 versus 63 +/- 9y; P < 0.0001), were less likely to be current tobacco smokers (30% versus 41%; P < 0.0001), had a higher incidence of diabetes (51% versus 33%; P < 0.0001), and had a lower incidence of cerebral vascular disease (18% versus 24%; P = 0.009) than non-obese patients. The two groups of patients had similar 30-d rates of mortality (1.3% versus 1.5%; P = 0.8) and major adverse cardiac events (2.3% versus 2.5%; P = 0.9). Adjusted Cox regression survival curves were also similar between the two groups of patients (adjusted hazard ratio, 1.2; 95% confidence interval, 0.8-1.8; P = 0.28). Obese patients who underwent CABG had 30-d mortality rates and early outcomes similar to those of non-obese patients. Long-term survival was also similar between these two groups of patients after adjustment for confounding variables.Journal of Surgical Research 03/2010; 163(1):7-11. DOI:10.1016/j.jss.2010.02.014 · 2.12 Impact Factor
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ABSTRACT: To establish if glucose management with continuous intravenous insulin infusion (CII) in the early post-operative period after coronary artery bypass graft (CABG) surgery is associated with complication rate and length of hospital stay (LOS) in patients with diabetes mellitus (DM). We reviewed the records of 587 patients with DM who underwent CABG from January 1999 until January 2008; 316 patients were placed on CII, while 271 patients were treated with subcutaneous insulin. We examined patient age, glycated hemoglobin (HgbA1c), 24- and 72-h post-operative average capillary blood glucose (CBG), length of stay (LOS), and the rate of complications. There was no difference in HgbA1c between the groups. Mean CBG values at both 24 h and 72 h remained the same in the CII group (167 mg/dl), while in the non-CII group they were 194 mg/dl and 189 mg/dl, respectively (p<0.001 between the groups). Post-surgical median LOS was 6 days in the CII group and 6.5 days in the non-CII group (p=0.003). Complications occurred at similar rate (in 10% and 11% of patients) in the two groups. CII is associated with a reduced post-surgical LOS in patients with DM who undergo CABG.Journal of endocrinological investigation 05/2011; 34(10):770-4. DOI:10.3275/7760 · 1.55 Impact Factor