Is body mass index a risk factor for isolated off-pump coronary revascularization?
| Autor: | Karikehalli A. Dilip, Castigliano M. Bhamidipati, Noah Cohen, Charles J. Lutz, Roberta Rolland, Keri A. Seymour |
|---|---|
| Rok vydání: | 2011 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Coronary Artery Bypass Off-Pump New York Renal function Coronary Artery Disease law.invention Body Mass Index law Risk Factors Diabetes mellitus Internal medicine medicine Humans Obesity Risk factor Aged Retrospective Studies Ejection fraction business.industry Incidence Middle Aged medicine.disease Intensive care unit Surgery Survival Rate Cardiology Female Cardiology and Cardiovascular Medicine business Complication Body mass index Follow-Up Studies |
| Zdroj: | Journal of cardiac surgery. 26(6) |
| ISSN: | 1540-8191 |
| Popis: | Objective: The influence of body mass index (BMI) as a risk factor for isolated off-pump coronary artery bypass (OPCAB) surgery is unknown. We postulated that BMI ≥ 30 kg/m2 would adversely affect outcomes following OPCAB at our institution. Methods: From 2002 to 2009, we selected 742 patients (primary, N = 709 [95.6%], re-operative, N = 33 [4.45%]) who underwent isolated OPCAB for analysis. Patients were stratified into groups by BMI: non-obese (BMI < 30 kg/m2) and obese (BMI ≥ 30 kg/m2). Preoperative risk, operative characteristics, and postoperative outcomes were analyzed. Risk-adjusted models evaluated the occurrence of any complication and mortality. Results: Overall crude mortality was 1.5% (11/742). When compared to non-obese (26.12 ± 2.72 kg/m2) recipients, the obese (35.81 ± 5.69 kg/m2) comprised younger patients (62.46 ± 9.96 years, p < 0.001). Number of diseased vessels, Left ventricular ejection fraction, and baseline renal function was equivalent across groups. Diabetes (53.24%) and hypertension (90.59%) were more prevalent among obese patients (p < 0.001, respectively). Internal mammary artery utilization (p = 0.47), endoscopic vein harvest (p = 0.74), and intra-aortic balloon pump use (p = 0.58) were similar between groups. Interestingly, postoperative blood product requirement was lower in obese versus non-obese recipients (47.35% vs. 56.72%, p < 0.01). Furthermore, intensive care unit stay (p = 0.93), mortality (p = 0.56), and discharge to home (p = 0.09) remained equivalent between groups. Importantly, multivariable logistic regression did not identify BMI ≥ 30 kg/m2 as an independent predictor of any complication (p = 0.21) or mortality (p = 0.74). Conclusions: Obesity does not influence operative characteristics or effect outcomes after OPCAB. BMI ≥ 30 kg/m2 should not be considered a prohibitive risk factor in isolated off-pump coronary revascularization. (J Card Surg 2011;26:565-571) |
| Databáze: | OpenAIRE |
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