Obesity and early complications after cardiac surgery.
OBJECTIVE
To assess the prevalence of obesity in patients undergoing coronary artery bypass grafting, heart valve surgery, or both procedures, and its association with postoperative outcomes.


METHODS
Retrospective analysis of data, collected by the Australasian Society of Cardiac and Thoracic Surgeons Victorian Cardiac Surgery Database Project, on patients undergoing coronary artery bypass grafting, heart valve surgery, or both procedures, between 1 June 2001 and 31 January 2006.


METHODS
11 736 patients divided into four groups: underweight (body mass index [BMI], < 20), normal weight (BMI, 20-30), obese (BMI, > 30 to < 40), and morbidly obese (BMI, >/= 40).


METHODS
Prevalence of obesity (compared with the age- and sex-matched adult Australian population); associations between obesity and morbid obesity in cardiac patients and adverse postoperative outcomes.


RESULTS
30.4% of patients had a BMI > 30 (28.6% obese, 1.8% morbidly obese) compared with an expected prevalence of 21.2%. Morbid obesity was associated with prolonged ventilation (adjusted odds ratio [OR], 2.4; 95% CI, 1.6-3.7), readmission to intensive care (adjusted OR, 2.2; 95% CI, 1.2-4.1), and length of stay > 14 days (adjusted OR, 2.1; 95% CI, 1.4-3.3). Both obesity and morbid obesity were associated with renal failure (adjusted ORs, 1.4 [95% CI, 1.1-1.7] and 2.9 [95% CI, 1.7-4.9], respectively) and deep sternal wound infection (adjusted ORs, 2.4 [95% CI, 1.5-3.8] and 7.2 [95% CI, 2.8-18.7], respectively).


CONCLUSIONS
Obesity is 1.4 times more prevalent in patients having coronary artery bypass grafting or heart valve surgery in Victoria compared with the general adult Australian population. Both obesity and morbid obesity are associated with early morbidity, but not mortality, after operation.
Yap
Cheng-Hon
CH
St Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia. cheng-hon.yap@svhm.org.au
Mohajeri
Morteza
M
Yii
Michael
M
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D016022:Case-Control Studies; D015331:Cohort Studies; D001026:Coronary Artery Bypass; D003422:Critical Care; D005260:Female; D006351:Heart Valves / Q000601:surgery; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D009767:Obesity, Morbid / Q000150:complications; D010359:Patient Readmission; D011183:Postoperative Complications; D051437:Renal Insufficiency / Q000209:etiology; D012121:Respiration, Artificial; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology; D013851:Thinness; D016896:Treatment Outcome