The Effects of Different BMI on Blood Loss and Transfusions in Chinese Patients Undergoing Coronary Artery Bypass Grafting.
OBJECTIVE
Blood loss is a predictor of outcomes after coronary artery bypass grafting (CABG). This study investigated the effects of body mass index (BMI) on blood loss, blood transfusion rate, and the variations in coagulation parameters of Chinese patients undergoing CABG.


METHODS
A total of 1007 Chinese patients who consecutively underwent isolated, primary CABG at Fuwai Hospital from January 1, 2013 to December 31, 2013 were included in this study. They were categorized by BMI into <24 kg/m2(low and normal weight group), 24≤ BMI <28 kg/m2(overweight group), and BMI ≥28 kg/m2(obese group). Following this BMI classification, the quantities of blood lost and recorded transfusions were analyzed.


RESULTS
Blood loss and transfusion rates were significantly higher in the low and normal weight group compared with the obese group (p <0.01). Chest tube drainage over 24 h, duration of intensive care unit (ICU) stay, and postoperative mechanical ventilation were higher as well (p <0.01). Atrial fibrillation was closely related to blood transfusion (p <0.001).


CONCLUSIONS
Obesity is a predictor for protection against blood loss and transfusion in Chinese people. Patients with low and normal BMI lost more blood per kg of their weight and had higher total transfused volume during isolated primary CABG. Atrial fibrillation was associated with high blood transfusion.
Department of Anesthesiology and Cardiovascular Surgery, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Mingya
M
Wang
Erduosi Hospital, Inner Mongolia, China.
Ming
M
Chen
Department of Anesthesiology and Cardiovascular Surgery, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Hushan
H
Ao
Department of Anesthesiology and Cardiovascular Surgery, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Sipeng
S
Chen
Erduosi Hospital, Inner Mongolia, China.
Zhifa
Z
Wang
D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D015992:Body Mass Index; D002681:China; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000175:diagnosis; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013851:Thinness / Q000150:complications* / Q000175:diagnosis; D013997:Time Factors; D065227:Transfusion Reaction; D016896:Treatment Outcome
BMI; CABG; blood loss; obesity