The effect of body mass index on early postoperative clinical outcomes following off-pump coronary artery bypass grafting / 中华胸心血管外科杂志

ABSTRACT

Objective To investigate the effect of body mass index on early postoperative clinical outcomes following off-pump coronary artery bypass grafting. Methods A total of 1062 patients that received OPCABG in Beijing Anzhen Hospital were recorded continuously from January 2015 to May 2015. The patients were divided into normal weight group(n=360), overweight group(n=527) and obesity group(n=175) according to their body mass index. The following outcomes in the ear-ly postoperative period were compared among the three groups hospital mortality, atrial fibrillation and intra aortic balloon counter pulsation usage, multiple organ failure score system, postoperative score for cardiac surgery, sequential organ failure assessment score, respiratory index, and pressure-adjusted heart rate. Results The lowest mortality rate was observed in the overweight group(0.6％) in comparison with the normal weight group(2.2％) and obesity group(1.1％)(P<0.01). The lowest rate of atrial fibrillation was observed in the obesity group(20. 1％) in comparison with the normal weight group (22.1％) and overweight group(20. 7％)(P <0. 01). The IABP usage rate was the highest in the normal weight group (8. 1％), followed by the overweight group(6. 0％) and the obesity group(2. 9％)(P<0. 01). On the operation day and the first day after operation, the MODS, SOFA and PSCS scores of the obese group were significantly higher than those of the nor-mal weight group(P <0. 01). PaO2/FiO2 in the obese group was significantly lower than that in the normal weight group (P<0. 01). PAHR in the obese group was significantly higher than that in the normal weight group(P<0. 01). Conclusion High BMI groups were associated with lower rates of mortality, atrial fibrillation, and IABP utilization. The lowest mortality rate was observed in the overweight group.