Association Between Body Mass Index, Obesity, and Clinical Outcomes Following Coronary Artery Bypass Grafting in Brazil: An Analysis of One Year of Follow-up of BYPASS Registry Patients.

Autor:	Ramos RS; Cardiology Postgraduate Program, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil., Rocco IS; Cardiology Postgraduate Program, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.; Cardiovascular Surgery Discipline, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil., Viceconte M; Cardiology Postgraduate Program, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil., Santo JADE; Instituto de Pesquisa - IP, Hospital do Coração - HCor, São Paulo, São Paulo, Brazil., Berwanger O; Instituto de Pesquisa - IP, Hospital do Coração - HCor, São Paulo, São Paulo, Brazil., Santos RHN; Instituto de Pesquisa - IP, Hospital do Coração - HCor, São Paulo, São Paulo, Brazil., Kalil RAK; Instituto de Cardiologia do Rio Grande do Sul, Fundação Universitária de Cardiologia, Porto Alegre, Rio Grande do Sul, Brazil., Jatene FB; Instituto de Pesquisa - IP, Hospital do Coração - HCor, São Paulo, São Paulo, Brazil.; Cardiovascular Surgery Division, Instituto do Coração - InCor, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - HCFMUSP, São Paulo, São Paulo, Brazil., Cavalcanti AB; Instituto de Pesquisa - IP, Hospital do Coração - HCor, São Paulo, São Paulo, Brazil., Zilli AC; Cardiology Postgraduate Program, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil., Pimentel WS; Cardiovascular Surgery Discipline, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil., Hossne NA Junior; Cardiovascular Surgery Discipline, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil., Branco JNR; Cardiovascular Surgery Discipline, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil., Trimer R; Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil., Evora PRB; Department of Surgery and Anatomy, Escola de Medicina de Riberão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil., Gomes WJ; Cardiology Postgraduate Program, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.; Cardiovascular Surgery Discipline, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil., Guizilin S; Cardiology Postgraduate Program, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.; Cardiovascular Surgery Discipline, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	Brazilian journal of cardiovascular surgery [Braz J Cardiovasc Surg] 2024 Apr 03; Vol. 39 (2), pp. e20230133. Date of Electronic Publication: 2024 Apr 03.
DOI:	10.21470/1678-9741-2023-0133
Abstrakt:	Objective: To investigate the association between body mass index (BMI), obesity, clinical outcomes, and mortality following coronary artery bypass grafting (CABG) in Brazil using a large sample with one year of follow-up from the Brazilian Registry of Cardiovascular Surgeries in Adults (or BYPASS) Registry database. Methods: A multicenter cohort-study enrolled 2,589 patients submitted to isolated CABG and divided them into normal weight (BMI 20.0-24.9 kg/m2), overweight (BMI 25.0-29.9 kg/m2), and obesity (BMI > 30.0 kg/m2) groups. Inpatient postoperative outcomes included the most frequently described complications and events. Collected post-discharge outcomes included rehospitalization and mortality rates within 30 days, six months, and one year of follow-up. Results: Sternal wound infections (SWI) rate was higher in obese compared to normal-weight patients (relative risk [RR]=5.89, 95% confidence interval [CI]=2.37-17.82; P=0.001). Rehospitalization rates in six months after discharge were higher in obesity and overweight groups than in normal weight group (χ=6.03, P=0.049); obese patients presented a 2.2-fold increase in the risk for rehospitalization within six months compared to normal-weight patients (RR=2.16, 95% CI=1.17-4.09; P=0.045). Postoperative complications and mortality rates did not differ among groups during time periods. Conclusion: Obesity increased the risk for SWI, leading to higher rehospitalization rates and need for surgical interventions within six months following CABG. Age, female sex, and diabetes were associated with a higher risk of mortality. The obesity paradox remains controversial since BMI may not be sufficient to assess postoperative risk in light of more complex and dynamic evaluations of body composition and physical fitness.
Databáze:	MEDLINE
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