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Cardiac surgery in patients with body mass index of 50 or greater

Mauricio A Villavicencio1, Thoralf M Sundt, Richard C Daly

  • 1Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.

The Annals of Thoracic Surgery
|March 27, 2007
PubMed

Insights

Cardiac surgery for patients with a body mass index (BMI) of 50 or higher presents significant challenges. This study found increased resource use and common complications, highlighting the need for careful management in this high-risk population.

Area of Science:

  • Cardiology
  • Bariatric Surgery
  • Critical Care Medicine

Background:

  • Rising global obesity rates present new challenges for healthcare systems.
  • Increasing demand for cardiac surgical interventions in extremely obese patients (BMI ≥ 50).
  • Limited established data on risks, benefits, and resource needs for this patient group.

Purpose of the Study:

  • To evaluate the outcomes and resource utilization of cardiac surgery in patients with a BMI of 50 or greater.
  • To identify predictors of mortality and major perioperative complications in this cohort.

Main Methods:

  • Retrospective analysis of 57 patients with BMI ≥ 50 undergoing cardiac surgery between 1993 and 2004.
  • Data collected included demographics, comorbidities (diabetes, hypertension, hyperlipidemia, sleep apnea), operative details, and outcomes.
  • Statistical analysis included univariate assessment to identify predictors of mortality and complications.

Main Results:

  • Operative mortality was 7%. Prolonged intubation (20%) and wound complications (5%) were observed.
  • Mean intensive care unit stay was 5 days; 1- and 5-year survival rates were 93% and 76%, respectively.
  • BMI > 54 predicted renal failure and prolonged mechanical ventilation; age and endocarditis predicted mortality.

Conclusions:

  • Cardiac surgery in patients with BMI ≥ 50 is associated with substantial resource utilization.
  • Prolonged intensive care unit and hospital stays are common.
  • Higher BMI, age, and endocarditis are associated with adverse outcomes, necessitating specialized care protocols.
Abstract

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