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Eur J Cardiothorac Surg 2004;26:535-541
© 2004 Elsevier Science NL

Influence of obesity on in-hospital and early mortality and morbidity after myocardial revascularization

Department of Thoracic and Cardiac Surgery, 414, Heart center, Nijmegan University Hospital, St Radboud, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands

Received 3 March 2004; received in revised form 12 May 2004; accepted 20 May 2004.

^* Corresponding author. Tel.: +31-24-361-3711; fax: +31-24-354-0129
e-mail: l.noyez{at}thorax.umcn.nl

Objective: Obese patients are thought to have an increased risk for complications in coronary artery bypass surgery. Several risk stratification systems do not identify obesity as a variable for risk adjustment. The aim of this study is to evaluate the in-hospital and early (one year) mortality and morbidity in obese and non-obese patients after a CABG in the UMC St Radboud. Methods: The data of 1130 patients undergoing a myocardial revascularization from January 2000 to August 2002 were analyzed. Obesity was measured by the body mass index (BMI). A BMI30 kg/m² was defined as obese. We compared 206 obese patients with 924 non-obese patients. Uni- and multivariate analysis were used to analyze the results. The 1-year survival was analyzed using Kaplan–Meier methods. Results: There were no significant differences between obese and non-obese patients according to postoperative myocardial infarction, re-operation for bleeding, in-hospital mortality, renal complications, neurological complications, pulmonary complications, gastrointestinal complications, re-intubation, re-admission on intensive care, ventilation time, days on intensive care, days in hospital and late mortality. Only the incidence of postoperative wound infections was increased in obese patients, 8.3% in the obese versus 4.4% in the non-obese (P=0.02). Multivariate analysis identified obesity only as risk factor for postoperative for wound infections (P=0.04, odds ratio: 1.97). Conclusions: Obese patients do not have an increased risk of in-hospital and early (1 year) mortality after CABG. However, obese patients have an increased risk of postoperative wound infections compared to non-obese patients.

Key Words: Myocardial revascularization • Obesity • Mortality • Morbidity

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				G. Filardo, C. Hamilton, B. Hamman, and P. Grayburn Obesity and Stroke After Cardiac Surgery: The Impact of Grouping Body Mass Index Ann. Thorac. Surg., September 1, 2007; 84(3): 720 - 722. [Full Text] [PDF]

				P. Totaro, N. Degno, and V. Argano CABG in obese patient: is the degree of obesity the key factor? Eur. J. Cardiothorac. Surg., March 1, 2005; 27(3): 530 - 530. [Full Text] [PDF]

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