What is the clinical evidence from this study?

Study design: Cohort. Population: Congenital heart disease requiring pulmonary valve replacement (n=71). Intervention: Obesity (BMI ≥30 kg/m2) vs. Nonobese patients. Primary outcome: Postoperative arrhythmias (OR 4.2, 95% CI 1.7-40, p=<0.01).

April 27, 2015

The Impact of Obesity on Postoperative Outcomes in Adults with Congenital Heart Disease Undergoing Pulmonary Valve Replacement

Q: What are the key findings of this study?

Obesity was independently associated with an increased risk of postoperative arrhythmias compared to nonobese patients (29% vs 5.6%; OR 4.2; 95% CI 1.7-40; P<0.01).

Key Result

Obesity was independently associated with an increased risk of postoperative arrhythmias compared to nonobese patients (29% vs 5.6%; OR 4.2; 95% CI 1.7-40; P<0.01).

Study Design

Type

Cohort (n=71)

Structured PICO

Does obesity increase postoperative morbidity in adults with congenital heart disease undergoing pulmonary valve replacement?

Population

71 adults with congenital heart disease undergoing reoperation for pulmonary valve replacement, of whom 24% were obese.

Exposure

Obesity (defined as body mass index ≥30 kg/m2)

Comparator

Nonobese patients

Outcome

Postoperative outcomes including hospital length of stay and postoperative arrhythmiashard clinical

In adults with congenital heart disease undergoing pulmonary valve replacement, obesity is significantly associated with prolonged hospital stays and a higher risk of postoperative arrhythmias.

Main Result

Odds Ratio: 4.2 (95% CI 1.7–40)

Absolute Event Rate: 29% vs 5.6%

p-value: p=<0.01

Abstract

OBJECTIVE: The impact of obesity on surgical morbidity in adults with congenital heart disease is currently unknown. The aim of our study was to investigate the impact of obesity on postoperative outcomes in adults with congenital heart disease undergoing reoperation for pulmonary valve replacement. METHODS: A retrospective analysis was performed assessing the influence of obesity on surgical outcomes. Obesity was defined as a body mass index ≥30 kg/m2. RESULTS: The mean body mass index of the cohort was 25.9 ± 6.9 kg/m2 . The cohort included 71 patients with 17 patients (24%) being obese. There was no postoperative mortality. Obese patients had a longer hospital length of stay (6.6 vs. 4.7 days; P 5 days (odds ratio OR = 5.2; 95% confidence interval CI: 1.5-18.2, P = .01) and with increased postoperative arrhythmias (OR = 4.2; 95% CI: 1.7-40, P < .01). CONCLUSIONS: Obesity is associated with increased morbidity in adults with congenital heart disease undergoing pulmonary valve replacement, including longer hospitalization and higher risk for postoperative arrhythmias.

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