HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Manoj Kuduvalli Aung Y. Oo Brian M. Fabri Abbas Rashid Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kuduvalli, M. Articles by Rashid, A. Search for Related Content PubMed PubMed Citation Articles by Kuduvalli, M. Articles by Rashid, A. Related Collections Coronary disease

Eur J Cardiothorac Surg 2003;23:368-373
© 2003 Elsevier Science NL

The effect of obesity on mid-term survival following coronary artery bypass surgery

^a Department of Cardiothoracic Surgery,The Cardiothoracic Centre, Liverpool, UK
^b Department of Research and Development, The Cardiothoracic Centre, Liverpool, UK

Received 18 September 2002; received in revised form 3 December 2002; accepted 8 December 2002.

^* Corresponding author. Tel.: +44-0151-293-2412; fax: +44-0151-220-8573
e-mail: arashid{at}ccl-tr.nwest.nhs.uk

Objective: Several studies have shown no significantly increased risk of in-hospital mortality for obese patients after coronary artery bypass grafting (CABG). However, the effect of obesity on mid-term survival has not been adequately studied. We set out to examine whether mid-term survival following CABG is affected by obesity. Methods: We performed a retrospective study of 4713 consecutive patients undergoing isolated CABG between April 1997 and September 2001. Body mass index (BMI) was used as the measure of obesity, with 3429 patients categorised as non-obese (BMI<30 kg/m²), and 1284 patients as obese (BMI30 kg/m²). Patient records were linked to the National Strategic Tracing Service, which records all deaths in the community, to establish current vital status. Deaths occurring over time were described using Kaplan–Meier techniques. To control for differences in patient characteristics, we used Cox proportional hazards analysis to calculate adjusted hazard ratios (HR) and 95% confidence intervals (CI). Results: Three hundred and thirty (7.0%) deaths occurred during the study period, with a mean follow-up of 2.4±1.4 years. The crude HR of mid-term mortality for obese patients was 1.09 (95% CI 0.86–1.39; P=0.457). After adjustment for core pre-operative factors, the adjusted HR of mid-term mortality for obese patients was 1.28 (95% CI 1.01–1.64; P=0.048). The adjusted freedom from death in the obese patients at 30 days, 1, 2, 3, and 4 years was 97.9, 95.9, 94.2, 92.4 and 90.5%, respectively, compared with 98.4, 96.8, 95.5, 94.0 and 92.5% for the non-obese patients. Conclusions: Although in-hospital mortality after CABG does not seem to be adversely affected by obesity there appears to be a significant increase in mortality in obese patients during a 4-year follow-up period.

Key Words: Obesity • Coronary artery bypass surgery • Mid-term survival • Risk adjustment

This article has been cited by other articles:

				R. H. Habib, A. Zacharias, T. A. Schwann, C. J. Riordan, S. J. Durham, and A. Shah Effects of Obesity and Small Body Size on Operative and Long-Term Outcomes of Coronary Artery Bypass Surgery: A Propensity-Matched Analysis Ann. Thorac. Surg., June 1, 2005; 79(6): 1976 - 1986. [Abstract] [Full Text] [PDF]

				L. Noyez Reply to Totaro et al. Eur. J. Cardiothorac. Surg., March 1, 2005; 27(3): 530 - 531. [Full Text] [PDF]

				A. H. Lindhout, C. W. Wouters, and L. Noyez Influence of obesity on in-hospital and early mortality and morbidity after myocardial revascularization Eur. J. Cardiothorac. Surg., September 1, 2004; 26(3): 535 - 541. [Abstract] [Full Text] [PDF]