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Bodyweight affects mortality in an L-shape pattern in patients undergoing coronary bypass grafting
Bardia Lajevardi1,2, Armin Talle3, Mehrtash Hashemzadeh3
1Department of Medicine, University of California San Diego, San Diego, CA, USA.
Future Cardiology
|January 6, 2025
Summary
Cachexia significantly increases mortality risk after coronary artery bypass surgery (CABG), while overweight and obesity show a protective effect. This benefit diminishes in morbidly obese patients, highlighting complex body composition impacts on CABG outcomes.
Area of Science:
- Cardiovascular Surgery
- Clinical Outcomes Research
- Body Composition Analysis
Background:
- The association between body composition and adverse outcomes in coronary artery bypass surgery (CABG) remains debated.
- Previous studies have yielded conflicting results regarding the impact of varying body weights on surgical mortality.
Purpose of the Study:
- To investigate the influence of different body weight categories on in-hospital mortality among patients undergoing CABG.
- To clarify the role of cachexia, overweight, obesity, and morbid obesity as predictors of mortality after CABG.
Main Methods:
- Utilized a large National Inpatient Sample (NIS) database from 2016-2020.
- Employed International Classification of Diseases, 10th Revision (ICD-10) codes to categorize patients by body weight (cachexia, overweight, obesity, morbid obesity).
- Performed multivariate analysis to adjust for age and comorbidities, assessing in-hospital mortality rates.
Main Results:
- Cachexia emerged as the strongest independent predictor of in-hospital mortality, associated with a nearly four-fold increase compared to normal weight.
- Overweight and obesity demonstrated a protective effect, significantly reducing mortality risk (OR 0.44 and 0.58, respectively).
- The mortality benefit of obesity was lost in morbidly obese patients, with a trend towards increased mortality (OR 0.9).
Conclusions:
- Cachexia is a significant risk factor for in-hospital mortality in CABG patients.
- Overweight and obesity appear to confer a protective effect against mortality post-CABG.
- Morbid obesity negates the protective benefits, indicating a potential increase in mortality risk at this extreme weight category.
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