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Severe obesity does not adversely affect perioperative mortality and morbidity in coronary artery bypass surgery
M Brandt1, K Harder, K P Walluscheck
1Department of Cardiovascular Surgery, University Hospital Kiel, Arnold-Heller-Strasse 7, 24105, Kiel, Germany. mbrandt@kielheart.uni-kiel.de
Insights
Severe obesity did not increase complications in coronary artery bypass grafting patients. This study found no significant differences in survival or adverse events between obese and non-obese individuals undergoing the procedure.
Area of Science:
- Cardiovascular Surgery
- Obesity Medicine
- Surgical Outcomes Research
Background:
- Obesity is often associated with increased surgical risks.
- Coronary artery bypass grafting (CABG) is a common cardiac procedure.
- The impact of severe obesity on CABG outcomes requires further investigation.
Purpose of the Study:
- To evaluate the association between severe obesity and perioperative outcomes in patients undergoing CABG.
- To compare morbidity and mortality rates in obese versus non-obese CABG patients.
Main Methods:
- Retrospective analysis of 500 consecutive CABG patients (1998).
- Severe obesity defined as body mass index (BMI) >= 30.0 kg/m(2).
- Comparison of 100 obese patients (group O) with 400 non-obese patients (group C) on various clinical and surgical parameters.
Main Results:
- No significant differences in survival or complications were observed between obese and non-obese groups.
- Complications analyzed included perioperative myocardial infarction, infections, renal failure, stroke, and prolonged ventilation.
- Obese patients had a higher prevalence of diabetes and hypertension but were slightly younger.
Conclusions:
- Severe obesity (BMI >= 30.0 kg/m(2)) does not appear to adversely affect perioperative mortality or morbidity in CABG patients.
- These findings challenge the assumption of increased risk for obese individuals undergoing this specific cardiac surgery.
- Further research may explore specific management strategies for obese patients undergoing CABG.
Objective:
Obese patients are usually thought to have an increased risk for complications in coronary artery bypass surgery.
Methods:
Therefore, the data of 500 consecutive patients undergoing coronary artery bypass grafting at our department in 1998 by use of cardiopulmonary bypass were analyzed. Severe obesity was defined as body mass index (BMI) > or = 30.0 kg/m(2). Obese patients (n=100; group O) were compared to the remaining 400 patients (group C). Both groups were comparable with respect to sex, history of prior myocardial infarction, chronic obstructive pulmonary disease, previous stroke, duration of cardiopulmonary bypass, aortic cross-clamp time and number of distal anastomoses performed. Obese patients were slightly younger and diabetes and hypertension were more common in these patients.
Results:
Survival and potential complications including perioperative myocardial infarction, sternal wound infection, wound infection at the leg, renal failure, stroke, prolonged mechanical ventilation, pneumonia, reexploration for bleeding, and atrial arrhythmias were analyzed. No significant differences between obese and non-obese patients were detected.
Conclusion:
Severe obesity does not necessarily adversely affect perioperative mortality and morbidity in patients undergoing coronary artery bypass grafting in this study.