Does the anthropometric profile influence infection morbidity after coronary artery bypass grafting?

Abstract

Background Infection after cardiovascular surgery is multifactorial. We sought to determine whether the anthropometric profile influences the occurrence of infection after isolated coronary artery bypass grafting (CABG). Methods Between January 2011 and June 2016, 1777 consecutive adult patients were submitted to isolated coronary artery bypass grafting. Mean age was 61.7 ± 9.8 years and 1193 (67.1%) were males. Patients were divided into four groups according to the body mass index (BMI) classification: underweight (BMI < 18.5 kg/m2; N = 17, 0.9%), normal range (BMI: 18.5–24.99 kg/m2; N = 522, 29.4%), overweight (BMI: 25–29.99 kg/m2; N = 796, 44.8%), and obese (BMI > 30 kg/m2; N = 430, 24.2%). In‐hospital outcomes were compared and independent predictors of infection were obtained through multiple Poisson regression with a robust variation. Results Independent predictors of any infection morbidity were female sex (relative ratio [RR], 1.47; p = .002), age > 60 years (RR, 1.85; p < .0001), cardiopulmonary bypass > 120 min (RR, 1.89; p = .0007), preoperative myocardial infarction < 30 days (RR, 1.37; p = .01), diabetes mellitus (RR, 1.59; p = .0003), ejection fraction < 48% (RR, 2.12; p < .0001), and blood transfusion (RR, 1.55; p = .0008). Among other variables, obesity, as well as diabetes mellitus, were independent predictors of superficial and deep sternal wound infection. Conclusions Other factors rather than the anthropometric profile are more important in determining the occurrence of any infection after CABG. However, surgical site infection has occurred more frequently in obese patients. Appropriate patient selection, control of modifiable factors, and application of surgical bundles would minimize this important complication.

The Relationship Between Body Mass Index and In-Hospital Mortality in Patients Following Coronary Artery Bypass Grafting Surgery

“…One explanation for this paradox is that patients with higher BMI may have a lower postoperative bleeding volume and transfusion rate; thus, such patients may save blood products during on-pump CABG factor that contributes to higher survival rates (14). On the other hand, sternal wound infections are more prevalent in obese patients and prior studies have shown increased morbidity and mortality rates in obese patients (15)(16)(17).…”

Factors Influencing the Incidence of Pneumonia after Coronary Artery Bypass Grafting

“…It brings huge obstacles to the work and spirit of patients, as well as huge economic burden and labor loss to families and society [10]. Therefore, how to effectively promote the recovery of lung function of patients is also the focus of clinical intervention [11,12]. By analyzing the factors affecting pulmonary infection in patients undergoing CABG and proposing nursing measures and invasive examination methods, the occurrence of pulmonary infection can be further reduced.…”