Risk of morbidity and in-hospital mortality in obese patients undergoing coronary artery bypass surgery

Abstract

Obese patients are not associated with an increased risk of in-hospital mortality following coronary artery bypass surgery. In contrast, there is a significant increased risk of morbidities and post-operative length of stay in obese patients compared to non-obese patients.

Effects of body mass index on the early surgical outcomes after coronary artery bypass grafting

“…Similar to our findings, Kuduvalli et al [13] surveyed 4,713 patients who underwent isolated CABG and confirmed that obese patients were more likely to have prolonged mechanical ventilation. However, they found no association between BMI and mortality, stroke, MI, bleeding, or re-exploration, but they did find a significant association between obesity and sternal infection, which was inconsistent with our findings.…”

“…In addition, Jenkins and Moxham [29] also reported that obesity has adverse effects on pulmonary function through increased functional residual capacity, decreased vital capacity, and maximum voluntary ventilation; our findings are in consistence with previous reports. [11,13] Likewise, other authors have reported greater respiratory problems and subsequent longer mechanical ventilation times after CABG among underweight patients. [4,9] Based on our findings, it seems that the association between post-CABG pulmonary complications and preoperative BMI also follows a U-shaped pattern, with both very high and very low ranges.…”

“…However, this difference was not statistically significant. Some studies have found no significant association between a patient's BMI and mortality after CABG, [12][13][14]20,21] but others have proposed that being underweight is an independent predictor for post-CABG morbidity and mortality. [17,22,23] Rahmanian et al [9] determined that the highest mortality rate (4.6%) occurred in patients with a BMI <20 kg/m 2 , and this was true even though their study included those with a BMI >30 kg/m 2 .…”

“…[4][5][6][7] Although several studies have proposed obesity as a cause of increased mortality and morbidity after this procedure, [8,9] some authors believe that it plays no role. [10][11][12][13] In fact, some believe that the early mortality rate is higher in underweight patients compared with those who are overweight, obese, or morbidly obese after CABG. [14] Obesity has emerged as an endemic concern in developing countries like Iran.…”

Saphenous vein harvest wound complications: risk factors, identification, prevention, and management

“…Preoperative factors associated with increased incidence of SV infection include increased age, 10,11 female sex, 9,12-14 increased body mass index, 9,10,13,[14][15][16] and comorbidities such as DM, 9,[11][12][13]17 PVD, [11][12][13] low preoperative hemoglobin levels, 14 congestive heart failure, and chronic renal failure, whereas the peroperative factors include duration of surgery, open technique of harvesting, 1,18-21 harvesting from the leg with deep vein thrombosis, inappropriate use of electrocautery, and IABP use, and these factors are modifiable.…”