ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
The effect of obesity and body mass index on coronary artery bypass grafting
Suat Nail Ömeroğlu1, Deniz Göksedef1, Ozan Onur Balkanay1, Zeki Talas1, Cem Sayılgan2, Bilgehan Karadağ3, Gökhan İpek1
1İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, İstanbul
2İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Anestezi ve Reanimasyon Anabilim Dalı, İstanbul
3İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi, Kardiyoloji Anabilim Dalı, İstanbul
Background: In this study we investigated the effects of obesity on coronary artery bypass grafting (CABG).

Methods: A total of 312 patients who underwent CABG in our clinic between December 19, 2006 and June 19, 2009 were included in the study. Patients with a body mass index (BMI) <30 kg/m2 were compared with patients with a BMI ≥30 kg/m2. Then the patients were divided into six subgroups according to World Health Organization’s BMI classification as underweight, normal weight, pre-obese, mildly obese, moderately obese, and severely obese. Patients with normal BMI were compared with other five subgroups.

Results: Obese patients (n=87, 28%) had higher blood triglyceride levels (p=0.009), higher amount of postoperative drainage (p=0.007), higher saphenous vein local site infection rate (p=0.032), higher hypertension (p=0.006), higher chronic obstructive lung disease (p=0.016), higher diabetes mellitus (p=0.021) history than non-obese patients (n=225, 72%). Obese patients more frequently needed postoperative inotropic drug support (p=0.038). A higher percentage of obese patients was female patients (p<0.001). In subgroup analysis, it was found that 1% (n=3) of patients were underweight, 28% (n=88) were normal weight, 43% (n=134) were pre-obese, 19% (n=60) were mildly obese, 7% (n=22) were moderately obese, 2% (n=5) were severely obese. When we compared normal weight group with other subgroups, we found preoperative blood urea values were higher in underweight (p=0.009); mean age values were lower in pre-obese (p=0.029); smoking rates were lower in pre, mildly and moderately obese (p=0.011; p=0.026; p=0.047, respectively); total postoperative drainage amounts were lower in mild obese (p=0.003); blood triglyceride level were higher in both mildly and moderately obese (p=0.014; p=0.029, respectively); diabetes mellitus rates were higher in mildly obese (p=0.030); percentage of female patients were higher in mildly, moderately and severely obese (p=0.003; p=0.001; p=0.001, respectively); hypertension rates were higher in moderately obese (p=0.014) patients.

Conclusion: We found that patients with higher BMI values were mostly females, they had CABG in younger ages, had higher blood triglyceride levels and diabetes mellitus rates, higher needs of postoperative inotropic drug support and they suffered from a higher rate of local site infection. However, morbidity and mortality rates were comparable to other patients probably because of intensive care of obese patients in preoperative, operative and postoperative periods.

Keywords : Body mass index; coronary artery bypass surgery; obesity
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