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Morbid obesity increases perioperative morbidity in first-time CABG patients—should resources be redirected to weight reduction

2005; Elsevier BV; Volume: 105; Issue: 1 Linguagem: Inglês

10.1016/j.ijcard.2004.10.058

1874-1754

Maqsood M. Elahi, Govind Chetty, A Sosnowski, M. Hickey, Tomasz Spyt,

Hip and Femur Fractures

The medical literature is unclear whether severe obesity poses an increased mortality and morbidity risk in patients undergoing coronary artery bypass grafting (CABG) [1–3] Most studies have defined severe obesity as a BMI N30 or N34, however, anecdotally it is the morbidly obese (body mass index; BMI N40) patients that seem to do worse. We therefore reviewed the effect of morbid obesity (BMI N40) on perioperative morbidity and mortality in patients undergoing isolated first-time CABG. The data of 3002 patients undergoing isolated CABG at our institution between January 1998 and December 2002 were analysed. Overall 2294 (76.3% (95% CI 71.5– 77.3)) patients were classified as non-obese (BMI b30), 686 (22.8% (95% CI 20.9–23.9) patients as obese (BMI 30.1–40) and 22 (0.73% (92% CI 0.2–3.2)) as morbidly obese (BMI N40) when assessed by the BMI [4]. Preoperative and postoperative demographics, clinical data, haemodynamic status, complications and total costs of care were analysed from respective case notes. Data were expressed as meansFstandard error of the mean. Statistical analysis was performed using the SPSS software (SPSS Inc, Chicago, IL). A value of Pb0.05 was taken as significant. The overall incidence of in-hospital adverse outcomes for the morbidly obese cohort was as follows: stroke, 1.1% (95% CI 0.5–2.1); early postoperative atrial arrhythmia, 24.4% (95% CI 23.2–25.7); renal failure, 2.2% (95% CI 2.0–2.7); sternal wound infections, 1.8% (95% CI 1.0–2.3);