Key result
Severe obesity in female patients undergoing coronary artery bypass grafting was not associated with increased in-hospital mortality compared to normal-slightly obese patients (0.8% vs 1.2%), but significantly increased the 30-day re-hospitalization rate.
Why the study?
Does severe obesity increase in-hospital mortality and early postoperative morbidity in female patients undergoing isolated CABG?
Cohort (n=427)
No
Does severe obesity increase in-hospital mortality and early postoperative morbidity in female patients undergoing isolated CABG?
Absolute Event Rate: 0.8% vs 1.2%
p-value: p=0.49
In female patients undergoing CABG, severe obesity is not associated with increased in-hospital mortality but is linked to higher rates of 30-day re-hospitalization and wound problems.
Severe obesity may not raise in-hospital mortality risk after CABG in women but increases 30-day readmission; leaves open whether targeted strategies improve outcomes.
BACKGROUND: Female gender has been reported to be an independent risk factor for coronary artery bypass grafting (CABG) in European System for Cardiac Risk Evaluation. The effect of the body size on the CABG outcome is less clear. There is ongoing debate about obesity as a risk factor for adverse outcomes after cardiovascular procedures. The goal of this retrospective study is to evaluate the in hospital and early postoperative outcomes in severe obese, obese and normal-slightly obese female patients after CABG. METHODS: In a four year period a total of 427 female patients underwent isolated CABG under cardiopulmonary bypass. The patients were allocated into three groups according to the Body Mass Index (BMI) as follows; group 1: severe obese patients; BMI > 35, group 2: obese patients; 30≤BMI≤35, group 3: normal-slightly obese patients; BMI < 30. RESULTS: The patients in group 3 were older than the group1 and group 2 (65,6 ± 8,3 year vs 63,01 ± 8,0 and 63,57 ± 8,4 year p < 0,05). In group 1 diabetic patients were more than in group 2 and group 3 respectively (54,4% vs 43,4% and 40%, p < 0,05). Urgent operation was more in group 1 than in group 2 and 3 respectively (37,6% vs 17,2% and 21,2% p < 0,05). The patients in group 3 had significantly greater postoperative drainage at 24 h compared with values in group 1 and group 2 (647 ± 142 ml vs. 539 ± 169 ml and 582 ± 133 ml, p < 0,05). Mortality rate in group 1 was 0,8%, 0% in group 2 and 1,2% in group 3 respectively. Wound problem has occurred in 41 patients (9,6%).The percentage of postoperative wound problems was higher in group 1 but did not show statiscially difference. Following discharge a total of 43 (10,1%) patients re-hospitalized within 30 days. Re-hospitalization rate was 16,1% in group1, 9,8% in group 2 and 6,5% in group 3 (p < 0,05). CONCLUSION: This study may give an aspect for evaluations of the inhospital-early mortality and morbidity after CABG in female patients in different BMI. Severe obesity is not a risk factor in-hospital mortality in female patients. However, severe obese female patients appear to have more wound problems and re-hospitalization rate after CABG compared to obese and normal-slightly obese patients.
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Hilmi Tokmakoğlu (2010) conducted a cohort in Coronary artery disease requiring isolated CABG (n=427). Severe obesity (BMI > 35) vs. Obese (BMI 30-35) and normal-slightly obese (BMI < 30) was evaluated on In-hospital mortality (p=0.49). Severe obesity in female patients undergoing coronary artery bypass grafting was not associated with increased in-hospital mortality compared to normal-slightly obese patients (0.8% vs 1.2%), but significantly increased the 30-day re-hospitalization rate.
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