Fowler VG

Ghali WA

Gurkan S

Perrotta S

Porcu A

Uva MS

Journal of the American Heart Association : Cardiovascular and Cerebrovascular Disease


            Background
            Better understanding of the relationship between obesity and postsurgical adverse outcomes is needed to provide quality and efficient care. We examined the relationship of obesity with the incidence of early adverse outcomes and in‐hospital length of stay following coronary artery bypass grafting surgery.
          
          
            Methods and Results
            
              We analyzed data from 7560 patients who underwent coronary artery bypass grafting. Using body mass index (BMI; in kg/m
              2
              ) of 18.5 to 24.9 as a reference, the associations of 4
              BMI
              categories (25.0–29.9, 30.0–34.9, 35.0–39.9, and ≥40.0) with rates of operative mortality, overall early complications, subgroups of early complications (ie, infection, renal and pulmonary complications), and length of stay were assessed while adjusting for clinical covariates. There was no difference in operative mortality; however, higher risks of overall complications were observed for patients with
              BMI
              35.0 to 39.9 (adjusted odds ratio 1.35, 95%
              CI
              1.11–1.63) and ≥40.0 (adjusted odds ratio 1.56, 95%
              CI
              1.21–2.01). Subgroup analyses identified obesity as an independent risk factor for infection (
              BMI
              30.0–34.9: adjusted odds ratio 1.60, 95%
              CI
              1.24–2.05;
              BMI
              35.0–39.9: adjusted odds ratio 2.34, 95%
              CI
              1.73–3.17;
              BMI
              ≥40.0: adjusted odds ratio 3.29, 95%
              CI
              2.30–4.71). Median length of stay was longer with
              BMI
              ≥40.0 than with
              BMI
              18.5 to 24.9 (median 7.0 days [interquartile range 5 to 10] versus 6.0 days [interquartile range 5 to 9],
              P
              =0.026).
            
          
          
            Conclusions
            
              BMI
              ≥40.0 was an independent risk factor for longer length of stay, and infection was a potentially modifiable risk factor. Greater perioperative attention and intervention to control the risks associated with infection and length of stay in patients with
              BMI
              ≥40.0 may improve patient care quality and efficiency.
            
          </jats:sec

Tasuku Terada

Jeffrey A. Johnson

Colleen Norris

Raj Padwal

Weiyu Qiu

Arya M. Sharma

Wonita Janzen

Mary Forhan

Crossref

Journal of the American Heart Association

Severe Obesity Is Associated With Increased Risk of Early Complications and Extended Length of Stay Following Coronary Artery Bypass Grafting Surgery

Severe Obesity Is Associated With Increased Risk of Early Complications and Extended Length of Stay Following Coronary Artery Bypass Grafting Surgery

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