11 research outputs found
P63 190. La obesidad en cirugĂa cardĂaca
El motivo del presente estudio es valorar la obesidad, Ăndice de masa corporal (IMC) superior a 35 kg/m2, como predictor de morbimortalidad en pacientes sometidos a cirugĂa cardiovascular.MĂ©todosDe enero de 2006 a enero de 2010, 1.655 pacientes han sido intervenidos en nuestro centro. Setenta y nueve pacientes presentaban un IMC > 35. La edad media fue de 67 años. Cuarenta y cinco pacientes eran mujeres; 57% de pacientes fueron intervenidos de cirugĂa de revascularizaciĂłn coronaria; 38% de pacientes fueron sometidos a sustituciĂłn valvular, 5% de pacientes presentaban cardiopatĂa congĂ©nita. El 32% del total de pacientes se intervinieron con carácter urgente y el resto de forma electiva.ResultadosDiez pacientes presentaban obesidad mĂłrbida con IMC superior a 40 kg/m2, 27 pacientes eran hipertensos; 48 diabĂ©ticos; 40 enfermedad pulmonar obstructiva crĂłnica (EPOC) y 10 dislipĂ©micos. El IMC medio de las mujeres fue de 38,08 y el de los varones de 36,44. El EuroSCORE logĂstico medio del grupo fue de 2,7. La estancia media hospitalaria fue de 18 dĂas (0-90 dĂas). La mortalidad perioperatoria fue del 5%. El seguimiento medio tras el alta hospitalaria fue de 29 meses.Un 29% de pacientes presentaron complicaciones de su herida quirĂşrgica (6 requirieron resutura quirĂşrgica); 15% pacientes presentaron complicaciones respiratorias en forma de embolia pulmonar (TEP) y atelectasia.ConclusionesEn nuestra experiencia la obesidad es un factor de morbilidad que se asocia con mayor riesgo de presentar complicaciones respiratorias e infecciĂłn de herida quirĂşrgica
Gender-specific anthropometric markers of adiposity, metabolic syndrome and visceral adiposity index (VAI) in patients with obstructive sleep apnea
Obstructive sleep apnea often coexists with visceral adiposity and metabolic syndrome. In this study, we analysed gender-related differences in anthropometrics according to sleep apnea severity and metabolic abnormalities. In addition, the visceral adiposity index, a recently introduced marker of cardiometabolic risk, was analysed. Consecutive subjects with suspected obstructive sleep apnea (n = 528, 423 males, mean age ± standard deviation: 51.3 ± 12.8 years, body mass index: 31.0 ± 6.2 kg m(-2) ) were studied by full polysomnography (apnea-hypopnea index 43.4 ± 27.6 h(-1) ). Variables of general and visceral adiposity were measured (body mass index, neck, waist and hip circumferences, waist-to-hip ratio). The visceral adiposity index was calculated, and metabolic syndrome was assessed (NCEP-ATP III criteria). The sample included controls (apnea-hypopnea index 30 h(-1) , n = 329). When anthropometric variables were entered in stepwise multiple regression, body mass index, waist circumference and diagnosis of metabolic syndrome were associated with the apnea-hypopnea index in men (adjusted R(2)  = 0.308); by contrast, only hip circumference and height-normalized neck circumference were associated with sleep apnea severity in women (adjusted R(2)  = 0.339). These results changed little in patients without metabolic syndrome; conversely, waist circumference was the only correlate of apnea-hypopnea index in men and women with metabolic syndrome. The visceral adiposity index increased with insulin resistance, but did not predict sleep apnea severity. These data suggest gender-related interactions between obstructive sleep apnea, obesity and metabolic abnormalities. The visceral adiposity index was a good marker of metabolic syndrome, but not of obstructive sleep apnea