O efeito do índice de massa corporal sobre as complicações no pós-operatório de cirurgia de revascularização do miocárdio em idosos

Abstract

O efeito do índice de massa corporal sobre as complicações no pós-operatório de cirurgia de revascularização do miocárdio em idososThe effect of the body mass index on postoperative complications of coronary artery bypass grafting in elderly Abstract Objectives: To evaluate the effect of BMI (body mass index) in the postoperative period of elderly patients undergoing CABG.Methods: Cross-sectional retrospective study, carried out in academic hospital, with all patients (n=290), aged or above 60 years, undergone CABG, from August 2006 to July 2007. The patients were divided into tertiles of BMI (<22, 22-27,> 27kg /m²). The variables included in the study were collected from medical records of patients and analyzed by logistic regression in association with the categories of BMI.Results: In the group with malnutrition were found larger percentage of impaired lung, kidney, hospital stay and immediate surgical mortality; but without statistical significance. Among female patients, the group malnutrition and eutrophy, 61.5% had hospital stay for a period longer than seven postoperative days compared to 42.5% male patients (p=0.003). In the group with malnutrition was found association between the CPB time and renal dysfunction with p<0.001 and, in eutrophic group with p=0.04. Obesity obtained protective association for lung dysfunction (RR=0.99), readmissions (RR=0.45) and mortality (RR = 0.77), and risk factor for renal dysfunction (RR=1.12). Conclusions 525REIS, C ET AL -The effect of the body mass index on postoperative complications of coronary artery bypass grafting in elderly Bras Cir Cardiovasc 2008; 23(4): 524-529 Rev

Overweight And Obesity Repercussion In The Postoperative Of Myocardial Revascularization Surgery

“…The RI was the only statistically significant comorbidity (p = 0.004), for its prevalence among patients without excess of weight, in agreement with other reviewed studies, in which individuals with lower BMI had a higher frequency of RI (9,16) , probably because of protein-calorie malnutrition resulting from dietary restrictions, hormonal disturbances and loss of nutrients during dialysis (18) .…”

“…In some studies, a high BMI -indicating overweight or obesity -was not associated with postoperative complications, while other studies have shown a positive association between overweight, obesity and CABG postoperative complications (8)(9)(10)(11) .…”

Complicações que aumentam o tempo de permanência na unidade de terapia intensiva na cirurgia cardíaca

“…The complications of cardiac surgery may be related to pre-existing diseases such as previous pulmonary diseases, COPD, asthma, smoking [3,7,23,25], advanced age [7,16,18,23,30], poor nutritional status [38], obesity, diabetes [16,39], among others [25]. Among the most common complications we found atrial fibrillation and flutter, pulmonary congestion and stroke [7,15,22].…”

“…Cardiac surgery in the elderly is associated with high morbidity and mortality due to the high prevalence of comorbidities and lower functional reserve of these patients [4,30,37]. Low body mass index (BMI) may increase the frequency of postoperative complications in the elderly undergoing coronary artery bypass grafting [2,30,38,42].…”

Influência da força muscular respiratória pré-operatória na evolução clínica após cirurgia de revascularização do miocárdio

“…Isso neutraliza a possibilidade de interferência de fatores de risco como a maior mortalidade após cirurgia cardíaca encontrada entre mulheres 10 , maior risco de CPP associado a diferentes níveis de índice de massa corporal 16,22,23 e entre pessoas com mais de 70 anos 16,22 , especialmente aquelas com importantes alterações fisiopatológicas e pior condição clínica 1,24 .…”