Impact of obesity on early cardiac surgical outcomes in Egypt׃ Early outcomes of coronary artery bypass graft surgery

Abdallah, Amany G.; ElNewihy, Mostafa A.; Brik, Alaa; Salem, Abdel Megeed M.

doi:10.1016/j.jescts.2017.08.001

Cited by 4 publications

(10 citation statements)

References 17 publications

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“…Meanwhile, there was a statistically significant difference regarding sex and DM distribution. Male gender predominated in both groups; however, group A had more females than group A, a finding which is consistent with a previous Study [9].…”

Section: Discussionsupporting

confidence: 92%

“…Despite the difference in the preoperative patients' characteristics, operative data were comparable between groups. This finding is consistent with other studies [9,11,13] and could be attributed in our study to the standardized anesthetic and CPB techniques used in all patients, in addition, we did not use BIMA in all patients to decrease the risk of infectious complications.…”

Section: Ef: Ejection Fractionsupporting

confidence: 93%

“…Re-exploration occurred more in group A which is inconsistent to previous studies [9,12]. Group A had more patients with 4 grafts which increased the number of anastomosis and could contribute to the postoperative bleeding risk.…”

Section: Ef: Ejection Fractioncontrasting

confidence: 89%

“…Obesity increases the risk of hypertension and for every one-kilogram increase in body weight, an increase of blood pressure by 1 mmHg occurs [12]. Several studies confirmed the association between hypertension and obesity [9,11,12] which was not elicited by our study. This could be attributed to the difference in sex distribution between groups, in addition, the study did not include patients with markedly elevated BMI.…”

Section: Ef: Ejection Fractionsupporting

confidence: 68%

“…Smoking is more common in normal weight patients [9,10,12] which could confound the effect of obesity on the results of surgery. Consistent with previous studies [9,11,12], diabetes is more common in obese patients which contribute to the increased severity of the coronary artery disease and further increase the risk of surgery. We apply strict measures to control blood sugar level preoperatively in elective surgery and our target HbA1C is less than 7.5.…”

Section: Ef: Ejection Fractionmentioning

confidence: 99%

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Effect of Body Mass Index on Morbidity and Mortality in Patients Undergoing Coronary Artery Bypass Grafting

Shawky

Rizk

Saffan

et al. 2019

Egypt. Cardiothoracic. Surg.

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Background: Obesity affects cardiovascular morbidity and mortality, and it increases the risk of coronary artery disease. Despite that, several cardiac surgery risk stratification scores do not consider the effect of obesity on the outcomes. The objective of this research is to study the impact of body mass index (BMI) on morbidity and mortality after coronary artery bypass grafting (CABG) in Egyptian patients. Methods: This prospective cohort study included 200 patients who underwent CABG for atherosclerotic coronary artery disease. Patients were divided into two groups, group A: patients with BMI ≥ 25 Kg/m2 and group B: patients with BMI < 25 Kg/m2. The mean age in group A was 56± 4.95 years vs. 54± 5.5 years in group B (p= 0.102). Male patients presented 58% of the population in group A vs 74% in group B (p= 0.017). 60% of patients were hypertensive in group A compared to 63% in group B (p= 0.66) and 62%, and 48% were diabetics in group A and B respectively (p= 0.04). Results: Postoperatively, there was a significant increase in wound infection (40% vs 8%; p< 0.001), chest infection (47% vs. 10% p< 0.001), surgical re-exploration (28% vs. 1%; p< 0.001), prolonged ICU stays (5.3 ± 2.88 vs. 3.93 ± 1.71 days; p< 0.001), ward stay (11.28 ±8.9 vs. 5.48 ± 2.45 days; p< 0.001), mediastinitis (34% vs. 6%; p< 0.001), the occurrence of sternal wound sinus within 8 months (26% vs. 7%; p< 0.001), in group A more compared to group B. There was no difference in ejection fraction (54.2 ±7.38 vs. 54.7 ± 9.1%; p= 0.69) and mortality (4% vs. 2%; p= 0.68) between groups. Conclusions: BMI 25 Kg/m2 or higher is associated with increased infectious complications and prolonged stay after CABG; however, it did not affect mortality. Optimizing body weight is recommended before elective surgery.

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Section: Discussionsupporting

confidence: 92%

Section: Ef: Ejection Fractionsupporting

confidence: 93%

Section: Ef: Ejection Fractioncontrasting

confidence: 89%

Section: Ef: Ejection Fractionsupporting

confidence: 68%

Section: Ef: Ejection Fractionmentioning

confidence: 99%

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Effect of Body Mass Index on Morbidity and Mortality in Patients Undergoing Coronary Artery Bypass Grafting

Shawky

Rizk

Saffan

et al. 2019

Egypt. Cardiothoracic. Surg.

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Long-Term Outcomes of Laparoscopic Gastric Plication for Treatment of Morbid Obesity: a Single-Center Experience

et al. 2022

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Background Although laparoscopic gastric plication (LGP) has been mentioned in many studies, its practice has not yet been standardized. In addition, the outcomes remain conflicting, especially long-term ones. This study was conducted to elucidate the long-term consequences of LGP. Methods Retrospective analysis of patients with obesity underwent LGP at our institution between March 2010 and September 2014. Data were prospectively collected from our database. Results Of the 88 consecutive patients in the study period between 2010 and 2014, follow-up data out to 6 years was available in 60 LGP patients (68.18%). The mean age of the included patients was 41.3 ± 10 years. A total of 81.7% were females. We observed a significant BMI reduction out to 2 years (p < 0.001), a plateau at 3 and 4 years, and a significant BMI increase at 6 years (p < 0.01). %TWL at 2 years was 21.14% and 12.08% at 6 years. Weight regain was observed in 35 patients at 6 years to reach a rate of 58.3%. Predictors for weight regain at 6 years were disrupted plication fold, increased hunger, and non-adherence to regular exercise. The diabetes improvement rate was 66.6% at 6 years. There were 14 re-operations (23.3%): 1 emergency (1.6%) and 13 (21.6%) elective. There was no mortality. Conclusion At the 6-year follow-up visit, LGP has a much less durable effect on weight loss with a % EWL of 32% and a weight regain of 58.3% resulting in a high rate of revisions. Graphical abstract

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Total arterial complete revascularization versus combined complete revascularization in patients undergoing coronary artery bypass grafting: Early outcomes

Sallam

Elatafy

Sabry

2017

Journal of the Egyptian Society of Cardio-Thoracic Surgery

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Impact of obesity on early cardiac surgical outcomes in Egypt׃ Early outcomes of coronary artery bypass graft surgery

Cited by 4 publications

References 17 publications

Effect of Body Mass Index on Morbidity and Mortality in Patients Undergoing Coronary Artery Bypass Grafting

Effect of Body Mass Index on Morbidity and Mortality in Patients Undergoing Coronary Artery Bypass Grafting

Long-Term Outcomes of Laparoscopic Gastric Plication for Treatment of Morbid Obesity: a Single-Center Experience

Total arterial complete revascularization versus combined complete revascularization in patients undergoing coronary artery bypass grafting: Early outcomes

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