Objective: The main goal of this study is to identify risk predictors for all-cause mortality in patients undergoing Coronary Artery Bypass Grafting (CABG) based on Body Mass Index (BMI). Methods: All consecutive 4,871 patients undergoing isolated CABG between 2005 and 2021, were included in the study. Underweight (<19 kg/m2 ) (n=42), normal/obese (BMI= 19-39.9 kg/m2 ) (n=4,622), and morbidly obese (BMI ≥ 40 kg/m2 ) (n=215) patients were compared for preoperative characteristics. A propensity-adjusted analysis was used to compare the groups. Primary outcome were long-term incidence of death and Major Adverse Cardiovascular and Cerebrovascular Events (MACCE). Results: Preoperatively, mean age was 71.2 (normal/obese), vs. 75.5 (underweight) vs. 65.9 (morbidly obese) years old. Intraoperatively, morbidly obese patients had higher operating room time. Postoperatively, morbidly obese, and underweight patients had higher blood product transfusion and 30-day readmission rate. Primary outcome of all-cause mortality was normal/obese 528/4622 (11.3%) vs. underweight 11/42 (26.2%) vs. morbidly obese 32/215 (14.9%), p=0.003. MACCE was significantly higher in morbidly obese patients 17/215 (7.9%), p=0.024. Predictors for all-cause mortality in morbidly obese patients were non-white patients, diabetes, Peripheral Vascular Disease (PVD), STS ≥ 4%, dialysis, hypertension, Chronic Obstructive Pulmonary Disease (COPD), Ejection Fraction (EF) <50%, and Atrial fibrillation (Afib). Predictors for all-cause mortality in underweight patients were male gender, white race, STS ≥ 4%, dialysis, EF<50%, and hypertension. Conclusion: Death rate in underweight patients was two-fold compared to normal/obese patients and 57% higher compared to morbidly obese patients. MACCE rate was significantly higher in morbidly obese patients.

Periprocedural Risk Predictors and Body Mass Index Impact Long-Term Prognosis in Patients Undergoing Coronary Artery Bypass Grafting / Dokollari A, Sicouri S, Kjelstrom S, Montone G, Cameli M, Yoshi Y, Gemelli M, Hassanabad AF, Ghorpade N, Cabrucci F, Bacchi B, Bonacchi M, Ramlawi B, Wertan MA and Sutter FP. - In: CLINICS IN SURGERY. - ISSN 2474-1647. - STAMPA. - (2023), pp. 3672-3680. [10.25107/2474-1647.3672]

Periprocedural Risk Predictors and Body Mass Index Impact Long-Term Prognosis in Patients Undergoing Coronary Artery Bypass Grafting

Cabrucci F;Bacchi B;Bonacchi M
;
2023

Abstract

Objective: The main goal of this study is to identify risk predictors for all-cause mortality in patients undergoing Coronary Artery Bypass Grafting (CABG) based on Body Mass Index (BMI). Methods: All consecutive 4,871 patients undergoing isolated CABG between 2005 and 2021, were included in the study. Underweight (<19 kg/m2 ) (n=42), normal/obese (BMI= 19-39.9 kg/m2 ) (n=4,622), and morbidly obese (BMI ≥ 40 kg/m2 ) (n=215) patients were compared for preoperative characteristics. A propensity-adjusted analysis was used to compare the groups. Primary outcome were long-term incidence of death and Major Adverse Cardiovascular and Cerebrovascular Events (MACCE). Results: Preoperatively, mean age was 71.2 (normal/obese), vs. 75.5 (underweight) vs. 65.9 (morbidly obese) years old. Intraoperatively, morbidly obese patients had higher operating room time. Postoperatively, morbidly obese, and underweight patients had higher blood product transfusion and 30-day readmission rate. Primary outcome of all-cause mortality was normal/obese 528/4622 (11.3%) vs. underweight 11/42 (26.2%) vs. morbidly obese 32/215 (14.9%), p=0.003. MACCE was significantly higher in morbidly obese patients 17/215 (7.9%), p=0.024. Predictors for all-cause mortality in morbidly obese patients were non-white patients, diabetes, Peripheral Vascular Disease (PVD), STS ≥ 4%, dialysis, hypertension, Chronic Obstructive Pulmonary Disease (COPD), Ejection Fraction (EF) <50%, and Atrial fibrillation (Afib). Predictors for all-cause mortality in underweight patients were male gender, white race, STS ≥ 4%, dialysis, EF<50%, and hypertension. Conclusion: Death rate in underweight patients was two-fold compared to normal/obese patients and 57% higher compared to morbidly obese patients. MACCE rate was significantly higher in morbidly obese patients.
2023
3672
3680
Dokollari A, Sicouri S, Kjelstrom S, Montone G, Cameli M, Yoshi Y, Gemelli M, Hassanabad AF, Ghorpade N, Cabrucci F, Bacchi B, Bonacchi M, Ramlawi B, Wertan MA and Sutter FP
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Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1345491
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