The influence of body mass index on outcomes in patients undergoing cardiac surgery: does the obesity paradox really exist?

PloS One
Juan Carlos Lopez-DelgadoJosep L Ventura

Abstract

Obesity influences risk stratification in cardiac surgery in everyday practice. However, some studies have reported better outcomes in patients with a high body mass index (BMI): this is known as the obesity paradox. The aim of this study was to quantify the effect of diverse degrees of high BMI on clinical outcomes after cardiac surgery, and to assess the existence of an obesity paradox in our patients. A total of 2,499 consecutive patients requiring all types of cardiac surgery with cardiopulmonary bypass between January 2004 and February 2009 were prospectively studied at our institution. Patients were divided into four groups based on BMI: normal weight (18.5-24.9 kg∙m-2; n = 523; 21.4%), overweight (25-29.9 kg∙m-2; n = 1150; 47%), obese (≥ 30-≤ 34.9 kg∙m-2; n = 624; 25.5%) and morbidly obese (≥ 35kg∙m-2; n = 152; 6.2%). Follow-up was performed in 2,379 patients during the first year. After adjusting for confounding factors, patients with higher BMI presented worse oxygenation and better nutritional status, reflected by lower PaO2/FiO2 at 24h and higher albumin levels 48 h after admission respectively. Obese patients showed a higher risk for Perioperative Myocardial Infarction (OR: 1.768; 95% CI: 1.035-3.022; p = 0.037) and...Continue Reading

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Citations

Jul 28, 2016·Journal of Cardiothoracic and Vascular Anesthesia·Mei GaoHong Liu
Nov 24, 2016·Journal of Vascular Surgery·George GalyfosKonstantinos Filis
Oct 17, 2018·Current Medicinal Chemistry·Jacopo AgrimiVincenzo Lionetti
Apr 7, 2020·International Anesthesiology Clinics·Detlef Obal, Anupama Wadhwa
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Jan 18, 2019·International Journal of Environmental Research and Public Health·Lucyna ŚcisłoAntoni Szczepanik
May 20, 2020·Journal of Cardiothoracic and Vascular Anesthesia·Lucrecia María BurgosDaniel Navia

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Methods Mentioned

BETA
Coronary Arterial Bypass

Software Mentioned

PASW statistics
SPSS

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