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Isolated coronary artery bypass grafting in obese individuals: a propensity matched analysis of outcomes
Mahboob Alam1, Sahar Siddiqui, Vei-Vei Lee
1Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA. malam@bcm.tmc.edu
Insights
Obesity did not increase in-hospital mortality for coronary artery bypass grafting (CABG) patients. However, obesity was linked to higher risks of respiratory failure, renal issues, and surgical site infections after CABG.
Area of Science:
- Cardiovascular Surgery
- Obesity Research
- Patient Outcomes
Background:
- Conflicting data exists on obesity's effect on morbidity and mortality in isolated coronary artery bypass grafting (CABG) patients.
- Understanding these risks is crucial for optimizing surgical outcomes.
Purpose of the Study:
- To investigate the association between obesity and in-hospital mortality and morbidity after isolated CABG.
- To clarify the impact of obesity on various postoperative complications.
Main Methods:
- Retrospective cohort analysis of 13,115 patients undergoing CABG between 1995 and 2010.
- Patients were classified as obese (BMI ≥ 30.0 kg/m²) or non-obese (BMI < 30.0 kg/m²).
- Propensity-matched logistic regression analysis was used to assess outcomes.
Main Results:
- Obesity was not associated with increased in-hospital mortality (OR = 1.13, 95% CI 0.86-1.48) in propensity-matched analysis (n=8,442).
- Obesity was linked to higher rates of postoperative respiratory failure, renal insufficiency, sternal wound infection, and leg wound infection.
- Conversely, obesity was associated with a reduced risk of postoperative bleeding and re-operation for bleeding.
Conclusions:
- Obesity is not a risk factor for in-hospital mortality following isolated CABG.
- Obesity increases the risk of specific postoperative complications, including respiratory failure, renal failure, and surgical site infections.
- The findings highlight the complex relationship between obesity and CABG outcomes, emphasizing the need for targeted postoperative care.
Background:
There is conflicting data regarding the impact of obesity on morbidity and mortality in patients undergoing isolated coronary artery bypass grafting (CABG).
Methods And Results:
Retrospective cohort analysis of patients who underwent CABG from January 1, 1995, through July 31, 2010 was performed. Patients were classified as obese or non-obese (body mass index ≥ 30.0 kg/m(2) and <30.0 kg/m(2), respectively). The primary outcome was in-hospital mortality. Secondary outcomes included postoperative respiratory failure, postoperative stroke, postoperative myocardial infarction, sternal and leg wound infections, postoperative atrial fibrillation, postoperative ventricular tachycardia, postoperative renal failure and length of hospital stay. Propensity-matched stepwise multivariable logistic regression was performed. Of 13,115 patients, 4,619 (35.2%) were obese. In the propensity-matched logistic regression models (n = 8,442), obesity was not associated with postoperative mortality (odds ratio = 1.13, 95% confidence interval 0.86-1.48). However, obesity was associated with postoperative respiratory failure, postoperative renal insufficiency, sternal wound infection, and leg wound infection. Obesity was also associated with a decreased risk of postoperative bleeding and re-operation from bleeding.
Conclusions:
Obesity was associated with an increased risk of postoperative respiratory failure, postoperative renal failure, and surgical site infections. However, obesity was not associated with in-hospital mortality in patients undergoing CABG.
