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Association Between Body Mass Index, Obesity, and Clinical Outcomes Following Coronary Artery Bypass Grafting in Brazil: An Analysis of One Year of Follow-up of BYPASS Registry Patients.

Association Between Body Mass Index, Obesity, and Clinical Outcomes Following Coronary Artery Bypass Grafting in Brazil: An Analysis of One Year of Follow-up of BYPASS Registry Patients.

Authors :
Ramos, Rodrigo Santin
Rocco, Isadora Salvador
Viceconte, Marcela
do Espírito Santo, José Amalth
Berwanger, Otavio
Nakagawa Santos, Renato Hideo
Karam Kalil, Renato Abdala
Jatene, Fabio B.
Cavalcanti, Alexandre Biasi
Zilli, Alexandre Cabral
de Souza Pimentel, Walace
Hossne Junior, Nelson Américo
Rodrigues Branco, João Nelson
Trimer, Renata
Barbora Evora, Paulo Roberto
Gomes, Walter J.
Guizilin, Solange
Source :
Brazilian Journal of Cardiovascular Surgery; 2024, Vol. 39 Issue 2, p1-14, 14p, 1 Diagram, 5 Charts
Publication Year :
2024

Abstract

Objective: To investigate the association between body mass index (BMI), obesity, clinical outcomes, and mortality following coronary artery bypass grafting (CABG) in Brazil using a large sample with one year of follow-up from the Brazilian Registry of Cardiovascular Surgeries in Adults (or BYPASS) Registry database. Methods: A multicenter cohort-study enrolled 2,589 patients submitted to isolated CABG and divided them into normal weight (BMI 20.0-24.9 kg/m2 ), overweight (BMI 25.0-29.9 kg/m2 ), and obesity (BMI > 30.0 kg/m2 ) groups. Inpatient postoperative outcomes included the most frequently described complications and events. Collected post-discharge outcomes included rehospitalization and mortality rates within 30 days, six months, and one year of follow-up. Results: Sternal wound infections (SWI) rate was higher in obese compared to normal-weight patients (relative risk [RR]=5.89, 95% confidence interval [CI]=2.37–17.82; P=0.001). Rehospitalization rates in six months after discharge were higher in obesity and overweight groups than in normal weight group (χ2 =6.03, P=0.049); obese patients presented a 2.2-fold increase in the risk for rehospitalization within six months compared to normal-weight patients (RR=2.16, 95% CI=1.17–4.09; P=0.045). Postoperative complications and mortality rates did not differ among groups during time periods. Conclusion: Obesity increased the risk for SWI, leading to higher rehospitalization rates and need for surgical interventions within six months following CABG. Age, female sex, and diabetes were associated with a higher risk of mortality. The obesity paradox remains controversial since BMI may not be sufficient to assess postoperative risk in light of more complex and dynamic evaluations of body composition and physical fitness. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
01027638
Volume :
39
Issue :
2
Database :
Complementary Index
Journal :
Brazilian Journal of Cardiovascular Surgery
Publication Type :
Academic Journal
Accession number :
181233467
Full Text :
https://doi.org/10.21470/1678-9741-2023-0133