Influence of Body Mass Index on Outcomes of Patients Undergoing Surgery for Acute Aortic Dissection: A Propensity-Matched Analysis

Abstract

To determine whether body mass index ≥30 kg/m2 affects morbidity and mortality rates in patients undergoing surgery for type A acute aortic dissection, we conducted a retrospective study of 201 patients with type A dissection. Patients were divided into 2 groups according to body mass index (BMI): nonobese (BMI, <30 kg/m2; 158 patients) and obese (BMI, ≥30 kg/m2; 43 patients). Propensity score matching was used to reduce selection bias. The overall mortality rate was 19% (38/201 patients). The perioperative mortality rate was higher in the obese group, both in the overall cohort (33% vs 15%; P=0.01) and in the propensity-matched cohort (32% vs 12%; P=0.039). In the propensity-matched cohort, patients with obesity had higher rates of low cardiac output syndrome (26% vs 6%; P=0.045) and pulmonary complications (32% vs 9%; P=0.033) than those without obesity. The overall 5-year survival rates were 52.5% ± 7.8% in the obese group and 70.3% ± 4.4% in the nonobese group (P=0.036). In the propensity-matched cohort, the 5-year survival rates were 54.3% ± 8.9% in the obese group and 81.6% ± 6.8% in the nonobese group (P=0.018). Patients with obesity (BMI, ≥30 kg/m2) who underwent surgery for type A acute aortic dissection had higher operative mortality rates and an increased risk of low cardiac output syndrome, pulmonary complications, and other postoperative morbidities than did patients without obesity. Additional extensive studies are needed to confirm our findings.

Risk factors for low cardiac output syndrome in children with congenital heart disease undergoing cardiac surgery: a retrospective cohort study

“…A propensity score-matched analysis found that obese (BMI, ≥30 kg/m 2 ) patients who underwent surgery for type A acute aortic dissection had higher postoperative mortality rates. Moreover, a previous report stated that obesity was significantly associated with increased risk of LCOS and other postoperative morbidities [27]. However, in our study, there was no significant correlation between BMI and LCOS risk after cardiac surgery in CHD children.…”

Verification of hub genes in the expression profile of aortic dissection

“…Thoracic aortic dissection (TAD) is a common and life-threatening aortic disease [1]. Despite improvements in medical therapy and surgical or endovascular techniques in recent years, TAD still has a high morbidity and mortality rate [2].…”

Association of Body Mass Index With Postoperative Early Adverse Outcomes in Acute Type a Aortic Dissection Patients in Fujian Province, China: A Retrospective Study

“…Several previous studies have investigated the impact of BMI in the prognosis of cardiac disease [10,11] , but the conclusions remain in dispute. The present study is innovative to demonstrate the impact of BMI on postoperative early adverse outcomes in Chinese AAAD patients undergoing surgery.…”

“…Kreibich et al pointed out that obesity was not signi cantly associated with postoperative adverse outcomes in AAAD patients [11] . Lio et al reported that obese patients were more likely to develop postoperative mortality and adverse outcomes compared to non-obese patients [10] . Our ndings indicate that overweight and obese are at increased risk of postoperative early adverse outcomes in AAAD patients, which wasn't consistent with their studies.…”