Obesity and postoperative early complications in open heart surgery

Demir, Aslı; Aydınlı, Bahar; Güçlü, Çiğdem Yıldırım; Yazıcıoğlu, Hija; Saraç, Ahmet; Elhan, Atilla Halil; Erdemli, Özcan

doi:10.1007/s00540-012-1393-7

Cited by 23 publications

(21 citation statements)

References 42 publications

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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: 71%

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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Section: Discussionmentioning

confidence: 71%

Does Obesity Affect Early Results after Coronary Artery Bypass Grafting?

Aithoussa¹,

Atmani²,

Seghrouchni³

et al. 2017

WJCS

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“…Demir A et al [23] mentioned that obesity does not increase short term mortality for open heart surgery, however, it increases the risk of postoperative pulmonary complications and discharge with morbidity.…”

Section: Discussionmentioning

confidence: 99%

A Pictorial Review on the Role of 64-Slice HD MDCT in Detecting Post CABG Cardiothoracic Complications

Helmy¹,

Asbeutah²,

Elfiki³

et al. 2014

OJTS

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Aims: The aim of this study is to have a pictorial review on the role of 64-slice multi-detector computerized tomography (MDCT) in detecting post coronary artery graft (GABG) cardiothoracic complications. Materials & Methods: During the period from November 2012 to December 2013, a prospective evaluation of 40 patients with suspected post-operative cardiothoracic complications underwent MDCT coronary angiography in our clinical radiology department. Informed consent was obtained from all patients and the study had institutional review board approval. Descriptive statistics were used to analyze the data. Results: There were 35 males and 5 females, their mean age ± (SD) of 57 ± 3.9 years. A total of 60 grafts were available for evaluation. Two patients could not be evaluated due to clip-artifacts and advanced atherosclerotic disease. Eleven patients showed occluded graft (9) at proximal and distal (2) anastomosis. Seven patients showed pericardial effusion and pleural effusion (8). Two patients had chest wall infection with retrosternal extension and associated mediastinal involvement. One patient showed aneurysm at the re-implanted coronary artery after Bentall procedure, another patient had postoperative myocardial infarction, one patient showed dissection of the ascending aorta, one patient pseudoaneurysm of left ventricle, two patients localized pericardial hematoma, two patients pulmonary embolism, and two patients showed pneumonia. All these complications occurred from 1 -60 days from surgery. Conclusion: HD MDCT is an easy non-invasive technique which showed to be effective in diagnosis of most postoperative CABG cardiothoracic complications and is gaining more ground in difficult clinical situations. Keywords

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“…Although the association of obesity and PPC is well known [17][18][19] , some studies failed to show the direct correlation between obesity and PPC [20][21][22] . Recent studies have shown that BMI above 35 is linearly associated with increasing PPC; but such correlation is not evident in patients with BMI less than 35 [23,24] . There is 30% chances of developing PPC after abdominal surgery in patients with BMI of 40 and above [25] .…”

Section: Obesitymentioning

confidence: 93%

Prevention of Postoperative Pulmonary Complications-Multidisciplinary Approach

Upadhyay¹

2015

JAS

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Postoperative pulmonary complications (PPC) substantially increases the risk of morbidity, mortality, length of hospitalisation and has significant financial implications. Risks of postoperative pulmonary complications can be broadly divided into patient related, procedure related, anaesthesia related and postoperative care related. The prevention of PPC requires comprehensive multidisciplinary approach that include preoperative risk stratification and optimizations, intra-operative lung protective strategies, greater utilization of regional analgesia and avoidance of opioid analgesia, balancing intravenous fluid, minimising blood and blood product transfusion, fast tracking protocol for enhanced recovery, vigilance monitoring, physiotherapy and lung expansion manoeuvres including use of non-invasive ventilation in selected patients and other supportive care such as nutritional support, glycemic control, selective gastric drainage, thrombo-prophylaxis and early empirical antibiotic therapy in suspected infection and sepsis.

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Obesity and postoperative early complications in open heart surgery

Abstract: We found that obesity does not increase short-term mortality for open heart surgery; however, it increases the risk of postoperative pulmonary and gastrointestinal complications and discharge with morbidity.

Cited by 23 publications

References 42 publications

Does Obesity Affect Early Results after Coronary Artery Bypass Grafting?

Does Obesity Affect Early Results after Coronary Artery Bypass Grafting?

A Pictorial Review on the Role of 64-Slice HD MDCT in Detecting Post CABG Cardiothoracic Complications

Prevention of Postoperative Pulmonary Complications-Multidisciplinary Approach

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