Thorac Cardiovasc Surg 2007; 55(8): 491-493
DOI: 10.1055/s-2007-965599
Original Cardiovascular

© Georg Thieme Verlag KG Stuttgart · New York

Is Extreme Obesity a Risk Factor for Increased In-Hospital Mortality and Postoperative Morbidity after Cardiac Surgery? Results of 2251 Obese Patients with BMI of 30 to 50

C. A. Syrakas1 , P. Neumaier-Prauser1 , I. Angelis1 , T. Kiask1 , B. M. Kemkes1 , B. Gansera1
  • 1Cardiovascular Surgery, City Hospital Munich Bogenhausen, Munich, Germany
Further Information

Publication History

received April 25, 2007

Publication Date:
19 November 2007 (online)

Abstract

Objective: The number of patients with extreme obesity requiring cardiac surgery is increasing. The aim of the present study was to evaluate the perioperative outcome, complication rate and 30-day mortality of these patients. Methods: Data of 13 139 patients (9584 males, 3555 females) undergoing cardiac surgery from 1/94 to 12/04 were analyzed. We compared 2251 obese patients with a BMI of 30 to 50 (mean age 64.3 years; group A) with 10 888 non-obese patients (mean age 66.1 years; group B). The incidence of diabetes mellitus was 34.5 % in group A, and 24.2 % in group B. Results: Isolated CABG was performed in 1771 patients from group A (3.4 grafts/pt.) and in 8066 patients from group B (3.2 grafts/pt.). Concomitant procedures were performed in 460 patients (group A) vs. 2645 (group B). Frequency of bilateral internal thoracic artery grafting was 49.4 % (group A) vs. 44.9 % (group B). There were no significant differences between the two groups with regard to the duration of surgery (180 vs. 171 min), the number of reoperations for bleeding (4.7 % vs. 5.0 %), ventilation times, length of stay in the intensive care unit (2.6 vs. 2.4 days) or 30-day mortality (2.0 % vs. 2.8 %). The incidence of diabetes and occurrence of sternal dehiscence was higher in group A (1.6 % vs. 0.7 %; p < 0.01). Sternal complications were strongly associated with diabetes and the combined use of bilateral ITA grafts but not with isolated obesity. The incidence of sternal dehiscence was associated with the male gender (group A 1.9 % vs. 0.7 %; group B 0.9 % vs. 0.3 %). Conclusion: Severe obesity does not per se enhance perioperative mortality. A BMI of 30 to 50 combined with diabetes mellitus and bilateral ITA grafting increases the risk for sternal complications.

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Dr. Christina Anna Syrakas

Cardiovascular Surgery
City Hospital Munich Bogenhausen

Englschalkinger 77

81927 Munich

Germany

Phone: + 49 89 92 70 26 31

Fax: + 49 89 92 70 26 05

Email: csyrakas@yahoo.de