Impact of body mass index on outcome in patients undergoing coronary artery bypass grafting and/or valve replacement surgery

• Published in: Revista brasileira de cirurgia cardiovascular Vol. 30; no. 3; pp. 335 - 342
• Main Authors: Costa, Vinícius Eduardo Araújo, Ferolla, Silvia Marinho, Reis, Tâmara Oliveira dos, Rabello, Renato Rocha, Rocha, Eduardo Augusto Victor, Couto, Célia Maria Ferreira, Couto, José Carlos Ferreira, Bento, Alduir
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Cirurgia Cardiovascular 01-07-2015
• Subjects: Aged; Body Mass Index; Brazil; CARDIAC & CARDIOVASCULAR SYSTEMS; Cardiology; Cardiovascular disease; Cirurgia Torácica; Coronary Artery Bypass - methods; Coronary Artery Bypass - mortality; Epidemiologic Methods; Female; Heart surgery; Heart Valve Prosthesis Implantation - methods; Heart Valve Prosthesis Implantation - mortality; Humans; Implante de Prótese de Valva Cardíaca; Intensive Care Units; Length of Stay; Male; Middle Aged; Obesidade; Obesity; Obesity - complications; Postoperative Complications - etiology; Postoperative Complications - mortality; Reference Values; Revascularização Miocárdica; Risk Factors; SURGERY; Surgical outcomes; Treatment Outcome; Índice de Massa Corporal; Brazil; Body mass index; Obesity; Thoracic surgery; Mitral valve prolapse; Myocardial revascularization; Índice de Massa Corporal; Cirurgia Torácica; Revascularização Miocárdica; Obesidade; Implante de Prótese de Valva Cardíaca
• ISSN: 0102-7638; 1678-9741; 1678-9741
• DOI: 10.5935/1678-9741.20150027

This study aimed to analyze the impact of body mass index on outcomes of 101 patients undergoing coronary artery bypass grafting, valve replacement, or combined valve/ coronary artery bypass grafting surgery in a private hospital in Belo Horizonte, Brazil.
This was a prospective cross-sectional study of patients undergoing cardiac surgery from May 2009 to December 2012. All patients were followed up from the first day of admission until discharge or death. Patients were divided into three groups according to BMI: normal weight, overweight, and obese. The main outcome measure was the association between BMI and postoperative morbidities and mortality.
Multivariate analysis identified obesity as an independent predictor of increased risk of surgical reintervention (odds ratio [OR] 13.6; 95%CI 1.1 - 162.9; P=0.046) and reduced risk of bleeding (OR 0.05; 95% CI 0.09 - 0.69; P=0.025). Univariate analysis showed that obesity was associated with increased frequency of wound dehiscence (P=0.021). There was no association between BMI and other complications or mortality in univariate analysis. There was also no association between body mass index and duration of cardiopulmonary bypass, aortic clamping, mechanical ventilation, and intensive care unit or hospital stay.
Obese individuals undergoing coronary artery bypass grafting, valve replacement, or combined surgery have a higher postoperative risk of surgical reintervention and lower chances of bleeding.