Key result
Lowest preoperative modified BMI linked to ~2.5% in-hospital mortality versus higher tertiles after off-pump CABG.
Why the study?
Malnutrition is a prevalent yet underrecognized comorbidity in CABG patients, and modified BMI (albumin × BMI) has been proposed as a more accurate nutritional risk indicator.
Does lower preoperative modified BMI predict higher in-hospital mortality in patients undergoing off-pump CABG?
Cohort (n=6,667)
Yes
Does lower preoperative modified BMI predict higher in-hospital mortality in patients undergoing off-pump CABG?
Preoperative modified BMI (albumin × BMI) serves as a significant prognostic indicator for in-hospital mortality and complications following off-pump CABG.
Answers are grounded in this paper and cite their sources.
Modified BMI may refine preoperative risk assessment after off-pump CABG; hypothesis-generating and requires prospective validation before practice change.
Background: Malnutrition is a prevalent yet underrecognized comorbidity in coronary artery bypass grafting (CABG) patients. Modified BMI (mBMI), defined as albumin × BMI, has been proposed as a more accurate indicator of nutritional risk. This study examined the association between preoperative mBMI and in-hospital outcomes following Off-pump CABG (OPCABG). Methods: This retrospective cohort study included patients with coronary artery disease who underwent isolated OPCABG at eight cardiac centers. Patients were stratified into tertiles based on preoperative mBMI values. The primary endpoint was in-hospital mortality. Logistic regression and restricted cubic spline models were used to evaluate the association between mBMI and outcomes. Subgroup analyses were performed based on clinical characteristics including sex, age, renal function, and comorbidity burden. Results: Among 6,667 patients, the lowest mBMI tertile had higher in-hospital mortality (2.52 % vs 1.53 % vs 1.17 %), cerebral infarction (2.48 % vs 2.34 % vs 1.39 %), and dialysis rates (1.04 % vs 0.54 % vs 0.36 %) compared to higher tertiles (all P < 0.05). Restricted cubic spline analysis revealed an inverse association between mBMI and the odds of in-hospital mortality, with the lowest risk observed around mBMI 1300-1350. Subgroup analyses demonstrated this relationship was particularly significant among females, patients with eGFR ≤ 90, and those with ASA score > 3 (P for association = 0.023, 0.013, and 0.049, respectively). Conclusion: Chinese Clinical Trial Registry: Chictr2400085741.
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Wang et al. (2025) conducted a cohort in Coronary artery disease (n=6,667). Lowest tertile of preoperative modified BMI vs. Higher modified BMI tertiles was evaluated on In-hospital mortality (p=< 0.05). The lowest tertile of preoperative modified BMI was associated with higher in-hospital mortality compared to higher tertiles (2.52% vs 1.53% vs 1.17%; P<0.05) after off-pump CABG.
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