The varying effects of obesity and morbid obesity on outcomes following cardiac transplantation
| Autor: | J Nagendran, M D Moore, C M Norris, A Khani-Hanjani, M M Graham, D H Freed |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Endocrinology Diabetes and Metabolism Myocardial Infarction MEDLINE Medicine (miscellaneous) Coronary Disease Kaplan-Meier Estimate 030204 cardiovascular system & hematology Risk Assessment Alberta Morbid obesity 03 medical and health sciences Postoperative Complications 0302 clinical medicine Risk Factors Internal medicine mental disorders medicine Humans 030212 general & internal medicine Proportional Hazards Models Nutrition and Dietetics Proportional hazards model business.industry Patient Selection Middle Aged medicine.disease Obesity Obesity Morbid Transplantation Treatment Outcome surgical procedures operative cardiovascular system Physical therapy Heart Transplantation Female medicine.symptom Risk assessment business Weight gain Body mass index |
| Zdroj: | International Journal of Obesity. 40:721-724 |
| ISSN: | 1476-5497 0307-0565 |
| Popis: | The purpose of this study was to compare the outcomes of patients undergoing cardiac transplantation stratified by body mass index (BMI, kg m(-)(2)). The Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease registry captured 220 cardiac transplantations in Alberta, Canada from January 2004 to April 2013. All recipients were stratified by BMI into five groups (BMI:20, 20-24.9, 25-29.9, 30-34.9 and ⩾35). Patient characteristics were analyzed by analysis of variance and χ(2) analyses. Kaplan-Meier was used to examine survival differences. Preoperative characteristics demonstrated significant increases in metabolic syndrome, prior myocardial infarction and prior coronary artery bypass graft in patients with morbid obesity. Intra-operatively, there was an increase in cardiopulmonary bypass time in patients with morbid obesity (P0.01). Postoperative analysis revealed increased rates of early complications (30 days), associated with a BMI35. Long-term survival was also significantly decreased in patients with morbid obesity. Of interest, obesity (BMI, 30-34.9) was not associated with decreased survival. These findings suggest that, post-cardiac transplantation, patients who have a BMI ⩾35 have lower long-term survival compared with all other BMI groups. However, patients with BMI 30-34.9 did not have significantly worse outcomes and should not be excluded for heart transplantation based on BMI. |
| Databáze: | OpenAIRE |
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