Consequences of obesity in outcomes after cardiac surgery. Analysis of ARIAM registry

被引:7
作者
Curiel-Balsera, Emilio [1 ]
Munoz-Bono, Javier [1 ]
Rivera-Fernandez, Ricardo [1 ]
Benitez-Parejo, Nicolas [2 ]
Hinojosa-Perez, Rafael [3 ]
Reina-Toral, Antonio [4 ]
机构
[1] Hosp Carlos Haya, Unidad Cuidados Intens, Malaga, Spain
[2] Ctr Invest Bionied Red CIBER Costa Sol, Unidad Cuidados Intens, Malaga, Spain
[3] Hosp Virgen Rocio, Unidad Cuidados Intens, Seville, Spain
[4] Hosp Virgen Nieves, Unidad Cuidados Intens, Granada, Spain
来源
MEDICINA CLINICA | 2013年 / 141卷 / 03期
关键词
Cardiac surgery; Obesity; Complications; Mortality; BODY-MASS INDEX; RISK-FACTOR; EXTREME OBESITY; MORTALITY; MORBIDITY; IMPACT; PREVALENCE; MODERATE;
D O I
10.1016/j.medcli.2012.04.023
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background and objetive: Obesity is a disease that affects a large part of the population and has been associated with worse outcomes after cardiac surgery. The aim of our study is to evaluate the consequences of obesity related to postoperative complications, hospital length of stay and mortality. Methods: Observational, prospective, multicenter study of patients included in ARIAM registry of adult cardiac surgery between March 2008 to March 2011. We analyzed clinical variables, the surgical procedure, postoperative complications and mortality, comparing the group of patients with body mass index (BMI) greater or less than 30 kg/m(2). Results: The study included 4,172 patients with a mean age of 64.03 (SD 12.08) years, BMI 28.53 (4.7) and EuroSCORE 5.58 (2.91). In 1,490 patients (35.7%) BMI was greater than 30. There were no differences in the development of overall postoperative complications (33% in obese and non-obese 35.8%, P = .07), although there were less appreciated reoperation rate or stroke (P < .05), as well as further development postoperative renal failure (P = .009). After adjusting for severity and length of cardio by pass time, obese patients had lower mortality without being statistically significant. OR 0.94(0.79-1.04). There were no differences in ICU length of stay, but obese patients had greater Ward length of stay 9.04 (10.43) vs. 8.18 (9.2) days, P = .01. Conclusions: Obese patients undergoing cardiac surgery have a mortality, rate of complications and length of stay similar to non-obese. Obese patients required less reoperations but developed more frequently postoperative renal failure. (C) 2012 Elsevier Espana, S.L. All rights reserved.
引用
收藏
页码:100 / 105
页数:6
相关论文
共 28 条
[11]   Prevalence of overweight and obesity in elderly people in Spain [J].
Gutiérrez-Fisac, JL ;
López, E ;
Banegas, JR ;
Graciani, A ;
Rodríguez-Artalejo, F .
OBESITY RESEARCH, 2004, 12 (04) :710-715
[12]   Obesity [J].
Haslam, DW ;
James, WPT .
LANCET, 2005, 366 (9492) :1197-1209
[13]   Fat as an endocrine organ: Relationship to the metabolic syndrome [J].
Hutley, L ;
Prins, JB .
AMERICAN JOURNAL OF THE MEDICAL SCIENCES, 2005, 330 (06) :280-289
[14]   Is obesity a risk factor for mortality in coronary artery bypass surgery? [J].
Jin, RY ;
Grunkemeier, GL ;
Furnary, AP ;
Handy, JR .
CIRCULATION, 2005, 111 (25) :3359-3365
[15]  
KOSHAL A, 1985, CAN J SURG, V28, P331
[16]   Risk of morbidity and in-hospital mortality in obese patients undergoing coronary artery bypass surgery [J].
Kuduvalli, M ;
Grayson, AD ;
Oo, AY ;
Fabri, BM ;
Rashid, A .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2002, 22 (05) :787-793
[17]   Obesity and Cardiovascular Disease Risk Factor, Paradox, and Impact of Weight Loss [J].
Lavie, Carl J. ;
Milani, Richard V. ;
Ventura, Hector O. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2009, 53 (21) :1925-1932
[18]   Obesity and suppressed B-type natriuretic peptide levels in heart failure [J].
Mehra, MR ;
Uber, PA ;
Park, MH ;
Scott, RL ;
Ventura, HO ;
Harris, BC ;
Frohlich, ED .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2004, 43 (09) :1590-1595
[19]  
Moulton MJ, 1996, CIRCULATION, V94, P87
[20]  
PARSONNET V, 1989, CIRCULATION, V79, P3