Isolated Coronary Artery Bypass Grafting in Obese Individuals - A Propensity Matched Analysis of Outcomes -

Alam, Mahboob; Siddiqui, Sahar; Lee, Vei Vei; Elayda, McArthur A.; Nambi, Vijay; Yang, Eric; Jneid, Hani; Wilson, James M.; Ballantyne, Christie M.; Virani, Salim S.

doi:10.1253/circj.cj-10-1129

Cited by 35 publications

(34 citation statements)

References 52 publications

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“…Postoperative drainage amounts were higher in normal patients compared to obese ones in various reports (5,(16)(17)(18). This association can be explained by increased levels of endothelial dysfunction markers like fibrinogen and von Willebrand factor in obese patients associated with hypercoagulability (19).…”

Section: Discussionmentioning

confidence: 84%

“…Saleh et al (2) studied the risk factors of prolonged ventilation in patients undergoing CABG and they found that BMI>35 was a predictor for prolonged ventilation while Christian et al (3) indicated that obesity was not a risk factor. Alam et al (5) in their review of 13.115 patients reported increased incidence of pulmonary complications in obese patients. In our study, we documented that intubation times were higher in obese patients.…”

Section: Discussionmentioning

confidence: 99%

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Obesity is still a risk factor in coronary artery bypass surgery

Gürbüz¹,

Durukan²,

Salman³

et al. 2014

Anadolu Kardiyol Derg

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Objective: Even with the improvements in surgical techniques and perioperative care, obesity is still a risk factor for occurrence of adverse events following cardiac surgery. In this observational, retrospective study, we aimed to document the effects of obesity on surgical outcomes in patients undergoing coronary artery bypass surgery and find out the effects of improvements in cardiac surgery. Methods: Between January 2011 and March 2013, isolated coronary artery bypass surgery was performed on 790 patients. The body mass index values of the patients were calculated and patients were divided into two groups; below 30 were classified as non-obese group whereas above 30 were classified as obese group. The odds ratio was obtained by using univariate analysis in order to document the effects of obesity on outcomes.Results: There were 548 (69.3%) patients in non-obese group, whereas 242 (30.7%) patients in obese group. The cardiopulmonary bypass (80.47±23.58 vs. 80.89±28.46, p=0.449) and aortic clamp times (54.13±16.60 vs. 54.19±19.85, p=0.511) and number of bypass grafts (3.09±1.02 vs. 2.96±1.00, p=0.11) were comparable between the groups. The mean number of fresh frozen plasma used was higher in obese patients (1.37±1.75 vs. 1.48±4.63, p=0.02). Intubation time was higher in obese patients (10.57±6.87 vs. 12.71±35.31, p=0.014). Total amount of postoperative drainage was higher in non-obese patients (766.77±472.27 vs. 648.72±371.39, p<0.001). The superficial infection/mediastenitis (0.4% vs. 2.5%, p=0.012), dehiscence (0.2% vs. 3.7%, p<0.001) and postoperative renal failure rates (4.7% vs. 8.7%, p=0.031) were higher in obese patients. The incidence of atrial fibrillation was lower in obese patients (19.7% vs. 12.8%, p=0.019). The mortality (0.5% vs. 1.7%, p=0.210) and postoperative stroke rates (1.1% vs. 0.8%, p=1.000) were similar in both groups. Conclusion: We documented that obesity is still a risk factor for occurrence of postoperative adverse events. We believe that improved perioperative care together with meticulous regimens can improve postoperative outcomes in patients undergoing coronary artery bypass surgery.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Obesity is still a risk factor in coronary artery bypass surgery

Gürbüz¹,

Durukan²,

Salman³

et al. 2014

Anadolu Kardiyol Derg

View full text Add to dashboard Cite

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“…The prevalent form of manifestation of CAD in hospital admission, regardless of BMI, was the NSTEMI, a more serious medical condition than that found in a study comparing subjects with BMI < 30 and > 30 kg/m 2 , and finding a higher prevalence of UA in patients admitted to hospital (17) .…”

Section: Discussionmentioning

confidence: 65%

“…In general, it is known that the time of surgery is directly related to CPB time (19) . In some studies (17,20) in which there was statistically significant difference, the CPB time was lower in patients without excess of weight and overweight and higher in obese patients.…”

mentioning

confidence: 95%

Overweight And Obesity Repercussion In The Postoperative Of Myocardial Revascularization Surgery

Araujo

Araújo

Bezerra

2014

Rev. esc. enferm. USP

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RESUMENEstudio descriptivo, transversal y retrospectivo de abordaje cuantitativo, cuyo objetivo fue relacionar el Índice de Masa Corporal (IMC) a los eventos ocurridos en el postoperatorio de la cirugía de revascularización miocárdica. La recolección de datos se realizó entre abril y junio del 2012. Los participantes fueron divididos según su IMC en tres grupos: aquellos con estado nutricional normal, con sobrepeso y obesos. El análisis de datos se basó en la estadística descriptiva. Se encontró que los participantes eutróficos tuvieron más complicaciones, especialmente pulmonares. Ente los individuos con sobrepeso y obesidad destacaron las complicaciones cardiovasculares, teniendo los sujetos con obesidad peor pronóstico. Se concluyó que no existe asociación estadísticamente significativa entre la obesidad y el sobrepeso con la mayor frecuencia de complicaciones postoperatorias a pesar de la ocurrencia de complicaciones cardiovasculares en esos grupos. El conocimiento de esas posibles complicaciones posibilita la planificación adecuada de los cuidados de enfermería a partir de la práctica basada en la evidencia. DESCRIPTORES ABSTRACTThis is a descriptive, retrospective study with cross-sectional quantitative approach, which aimed to relate the body mass index with events in the postoperative period of the myocardial revascularization surgery with use of extracorporeal circulation. The data collection period was between April and June/2012. Patients were divided according to the body mass index and classified as without excess of weight, overweight or obese. The data analysis was based on the descriptive statistics. The patients without excess of weight had more complications, especially those related to the lungs. Among overweight and obese individuals, the cardiovascular complications stood out. The obese subjects had the worse prognostic. Obesity and overweight did not have statistically significant association with a higher frequency of postoperative complications, in spite of the occurrence of cardiovascular complications in this group. The patients without excess of weight had higher risks of developing neurological events.

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“…In recent study, Ranucci [35] and Khairudin [36] found that obese patients are at higher risk for postoperative hypoxia and prolonged ICU stay. In contrast to the published literature, Alam et al [27] and Demir et al [37] reported comparable ICU stay and hospital stay times in obese and non obese patients after CABG. There are disparate results on the association between the obesity and postoperative renal insufficiency.…”

Section: Discussionmentioning

confidence: 74%

Does Obesity Affect Early Results after Coronary Artery Bypass Grafting?

Aithoussa¹,

Atmani²,

Seghrouchni³

et al. 2017

WJCS

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Background: The aim of this study was to quantify the effect of obesity on early results after coronary artery bypass grafting (CABG). Methods: A retrospective cohort study of patients underwent isolated CABG from January 2000 through December 2012 was conducted. 586 patients were classified into two groups: Obese (n = 100) BMI ≥ 30 kg/m 2 and non-obese (n = 486) BMI ≤ 30kg/m 2 . Results: The obese patients included more women (p < 0.01), hypertensives (p = 0.01) and dyslipidemics (p = 0001). The CPB, aortic champ times and number of bypass graft were similar between the groups (p = 0.35, p = 0.51 and p = 0.59 respectively). Also the composite of in-hospital mortality and postoperative complication didn't differ between the groups. The incidence of perioperative myocardial infarction, and need for inotropic drugs or IABP were significantly less in obese patients (p = 0.028, p = 0.031 and p < 0.01 respectively). Conclusions: The current study showed that obesity is not a risk factor of adverse events after CABG and continuous to give another aspect of the "obesity paradox".

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Isolated Coronary Artery Bypass Grafting in Obese Individuals - A Propensity Matched Analysis of Outcomes -

Cited by 35 publications

References 52 publications

Obesity is still a risk factor in coronary artery bypass surgery

Obesity is still a risk factor in coronary artery bypass surgery

Overweight And Obesity Repercussion In The Postoperative Of Myocardial Revascularization Surgery

Does Obesity Affect Early Results after Coronary Artery Bypass Grafting?

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