Influence of obesity on in-hospital and early mortality and morbidity after myocardial revascularization.
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 BMI>or=30 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.
Department of Thoracic and Cardiac Surgery, 414, Heart center, Nijmegan University Hospital, St Radboud, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
Ariena H
AH
Lindhout
Constantijn W
CW
Wouters
Luc
L
Noyez
D000368:Aged; D000704:Analysis of Variance; D003327:Coronary Disease / Q000150:complications / Q000401:mortality / Q000601:surgery*; D048909:Diabetes Complications / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009204:Myocardial Revascularization / Q000401:mortality*; D009765:Obesity / Q000150:complications / Q000401:mortality* / Q000601:surgery; D011184:Postoperative Period; D012307:Risk Factors; D012737:Sex Factors