Key result
Body mass index was not associated with early postoperative mortality after CABG surgery, although underweight patients experienced more bleeding complications and obese patients had higher rates of wound infections and atrial fibrillation.
Why the study?
Does body mass index affect in-hospital mortality and morbidity in patients undergoing isolated CABG surgery?
Cohort (n=1,057)
Does body mass index affect in-hospital mortality and morbidity in patients undergoing isolated CABG surgery?
p-value: p=0.422
BMI does not independently predict early mortality after CABG, but extremes of BMI are associated with specific morbidities such as bleeding in underweight patients and infections or atrial fibrillation in obese patients.
BMI does not support withholding CABG based on mortality risk; leaves open targeted strategies for BMI-linked complications.
BACkGRouND: The impact of obesity on postoperative mortality and morbidity in coronary artery bypass grafting (CABG) operations is a widely studied but poorly defined topic. oBjECTIVE: To investigate the effect of body mass index (BMI) on inhospital mortality and morbidity after isolated CABG surgery. METhoDS: Prospectively collected data of a series of 1057 consecutive patients who underwent on-pump isolated CABG surgery were retrospectively analyzed. Patients were divided into five groups according to WHO BMI categorization (defined as underweight [BMI <20 kg/m2]; normal weight [BMI ≥20 kg/m2 to <25 kg/m2]; overweight [BMI ≥25 kg/m2 to <30 kg/m2]; obese [BMI ≥30 kg/m2 to <35 kg/m2]; and morbidly obese [BMI ≥35 kg/m2]). RESulTS: Of 1057 patients, 13 patients (1.2%) were underweight, 298 (28.2%) were normal weight, 462 (43.7%) were overweight, 218 (20.6%) were obese and 66 (6.2%) were morbidly obese. The mean age was significantly lower in underweight patients, who were also more likely to be male. In contrast, obese and morbidly obese patients were older, and more likely to have comorbidities such as diabetes and hypertension. The incidence of postoperative bronchodilator use (P<0.001), leg wound infection (P=0.038), sternal dehiscence (P=0.039) and development of new-onset atrial fibrillation (P<0.001) was significantly higher in obese and morbidly obese groups. In contrast, postoperative prolonged ventilation (P<0.001), need for blood transfusions (P<0.001) and revision for bleeding (P=0.041), as well as gastrointestinal complications (P<0.001), were significantly higher in underweight patients. Multivariate logistic regression analysis showed that female sex, older age and diabetes mellitis, but not BMI, were independent risk factors for early mortality after CABG surgery. CoNCluSIoN: No effect of BMI on early postoperative mortality after CABG surgery could be demonstrated. However, in terms of morbidity, postoperative bleeding and revision for bleeding were increased in underweight patients while sternal dehiscence, wound infections and occurrence of atrial fibrillation were increased in obese and morbidly obese patients.
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Gürkan et al. (2014) conducted a cohort in Coronary artery disease requiring CABG (n=1,057). Body mass index (BMI) vs. Normal weight (BMI ≥20 to <25 kg/m2) was evaluated on Early postoperative mortality (within 30 days) (p=0.422). Body mass index was not associated with early postoperative mortality after CABG surgery, although underweight patients experienced more bleeding complications and obese patients had higher rates of wound infections and atrial fibrillation.
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