Influence of obesity on in-hospital and early mortality and morbidity after myocardial revascularization

• Published in: European journal of cardio-thoracic surgery 2004-09, Vol.26 (3), p.535-541
• Main Authors: Lindhout, Ariena H., Wouters, Constantijn W., Noyez, Luc
• Format: Article
• Language: English
• Subjects: Aged; Analysis of Variance; Biological and medical sciences; Coronary Disease - complications; Coronary Disease - mortality; Coronary Disease - surgery; Diabetes Complications - mortality; Female; Follow-Up Studies; Humans; Hyperlipidemias - complications; Hypertension - complications; Male; Medical sciences; Middle Aged; Morbidity; Mortality; Myocardial revascularization; Myocardial Revascularization - mortality; Obesity; Obesity - complications; Obesity - mortality; Obesity - surgery; Postoperative Period; Risk Factors; Sex Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the heart
• ISSN: 1010-7940; 1873-734X
• DOI: 10.1016/j.ejcts.2004.05.034

Objective: Obese patients are thought to have an increased risk for complications in coronary artery bypass surgery. Several risk stratification systems do not identify obesity as a variable for risk adjustment. The aim of this study is to evaluate the in-hospital and early (one year) mortality and morbidity in obese and non-obese patients after a CABG in the UMC St Radboud. Methods: The data of 1130 patients undergoing a myocardial revascularization from January 2000 to August 2002 were analyzed. Obesity was measured by the body mass index (BMI). A BMI≥30 kg/m2 was defined as obese. We compared 206 obese patients with 924 non-obese patients. Uni- and multivariate analysis were used to analyze the results. The 1-year survival was analyzed using Kaplan–Meier methods. Results: There were no significant differences between obese and non-obese patients according to postoperative myocardial infarction, re-operation for bleeding, in-hospital mortality, renal complications, neurological complications, pulmonary complications, gastrointestinal complications, re-intubation, re-admission on intensive care, ventilation time, days on intensive care, days in hospital and late mortality. Only the incidence of postoperative wound infections was increased in obese patients, 8.3% in the obese versus 4.4% in the non-obese (P=0.02). Multivariate analysis identified obesity only as risk factor for postoperative for wound infections (P=0.04, odds ratio: 1.97). Conclusions: Obese patients do not have an increased risk of in-hospital and early (1 year) mortality after CABG. However, obese patients have an increased risk of postoperative wound infections compared to non-obese patients.