Effect of Body Mass Index on Early Morbidity and Mortality After Isolated Coronary Artery Bypass Graft Surgery

• Published in: Journal of cardiothoracic and vascular anesthesia 2012-10, Vol.26 (5), p.813-817
• Main Authors: Atalan, Nazan, MD, Fazlioğulları, Osman, MD, Kunt, Atike Tekeli, MD, Başaran, Cem, MD, Gürer, Onur, MD, Şitilci, Tolga, MD, Akgün, Serdar, MD, Arsan, Sinan, MD
• Format: Article
• Language: English
• Subjects: Aged; Anesthesia & Perioperative Care; Body Mass Index; coronary artery bypass; Coronary Artery Bypass - adverse effects; Coronary Artery Bypass - mortality; Critical Care; Female; Hospital Mortality - trends; Humans; Male; Middle Aged; Morbidity; mortality; overweight; Overweight - mortality; Overweight - surgery; Postoperative Complications - etiology; Postoperative Complications - mortality; Retrospective Studies; Risk Factors; Thinness - mortality; Thinness - surgery; Treatment Outcome; underweight
• ISSN: 1053-0770; 1532-8422
• DOI: 10.1053/j.jvca.2012.01.033

Objectives Obesity is a risk factor for morbidity after isolated coronary artery bypass grafting. This study aimed to analyze the sole effect of body mass index (BMI) on early morbidity and mortality in patients after isolated coronary artery bypass grafting. Design This study was retrospective and used an electronic database of anesthesia information management. Setting A single community hospital. Participants The data of 803 consecutive patients after isolated on-pump coronary artery bypass grafting were analyzed retrospectively; off-pump cases were excluded. Intervention According to measured BMI, patients were divided into 5 groups: underweight (BMI 34.9 kg/m2 ). Early postoperative morbidity and mortality were evaluated using logistic regression analysis. Measurements and Main Results Early cumulative postoperative mortality was 3.9% (32 of 803 patients). Mortality was recorded in 3 underweight (n = 15, 20%, odds ratio [OR] 6.54, p = 0.001), 9 normal-weight (n = 159, 5.7%, OR 1.62, p = 0.228), 12 overweight (n = 371, 3.2%, OR 0.68, p = 0.314), 6 obese (n = 199, 3.0%, OR 0.69, p = 0.421), and 2 morbidly obese (n = 59, 3.4%, OR 0.83, p = 0.808) patients. Prolonged intensive care unit stay ( p < 0.001), prolonged hospital stay ( p < 0.001), and mortality ( p = 0.01) were significantly more common in patients in the underweight group than in the other groups. Univariate and multivariate logistic regression analyses showed that underweight, hypertension, and chronic renal failure were independent risk factors for mortality. Conclusions Underweight patients with a BMI