title: The impact of obesity on early postoperative outcomes in adults with congenital heart disease.
abstract: BACKGROUND
  As the prevalence of obesity continues to increase, it now includes the growing number of patients with congenital heart disease (CHD). This particular obese patient population may pose additional intraoperative as well as postoperative challenges that may contribute to poor outcomes. Our aims were to determine the influence of obesity on morbidity and mortality in adults with CHD undergoing surgical repair at a free standing children's hospital.
  
  
  METHODS
  A retrospective analysis of adult (≥18 years) CHD surgery cases from 2002 to 2008 was performed. Congenital heart lesions were defined as mild, moderate, or complex. Patients were categorized by body mass index (BMI): underweight (BMI < 20 kg/m(2)), normal (BMI 20-24.9 kg/m(2)), overweight (BMI 25-29.9 kg/m(2)), and obese (BMI ≥ 30 kg/m(2)). Demographics, incidence of mortality, or specific morbidities were statistically compared using Fisher's exact test and analyses of variance (anovas).
  
  
  RESULTS
  In this population (n = 165), overweight (29%) and obese (22%) patients were prevalent. Hypertension (HTN) and pre-HTN were more prevalent in obese and overweight patients. Postoperative renal dysfunction was observed in obese patients with complex CHD (P = .04). Mortality was not different among groups.
  
  
  CONCLUSIONS
  Obesity is becoming increasingly common among adults with CHD. Despite marginal evidence of postoperative renal complications in obese patients with CHD of severe complexity, the overall presence of obesity did not influence mortality or short term postoperative morbidities.
authors.affiliation: The Adolescent and Adult Congenital Heart Disease Program, The Heart Center, Nationwide Children's Hospital, Columbus, Ohio 43205, USA. ali.zaidi@osumc.edu
authors.forename: Ali N
authors.initials: AN
authors.lastname: Zaidi
authors.forename: John A
authors.initials: JA
authors.lastname: Bauer
authors.forename: Marc P
authors.initials: MP
authors.lastname: Michalsky
authors.forename: Vincent
authors.initials: V
authors.lastname: Olshove
authors.forename: Bethany
authors.initials: B
authors.lastname: Boettner
authors.forename: Alistair
authors.initials: A
authors.lastname: Phillips
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Cook
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D015992:Body Mass Index; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology; D008297:Male; D009765:Obesity / Q000150:complications* / Q000401:mortality; D009820:Ohio; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult