Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, The Netherlands.
Ann Thorac Surg. 2010 Jan;89(1):30-7. doi: 10.1016/j.athoracsur.2009.09.050.
The effect of obesity on the long-term outcome after coronary artery bypass graft surgery (CABG) remains controversial. We analyzed data of patients undergoing CABG in a single center, to determine the predictive value of body mass index in combination with comorbidities on early and late mortality.
Early and late mortality of consecutive patients undergoing isolated CABG from January 1998 until December 2007 were determined. Patients were classified into five groups according to preoperative body mass index: underweight, normal weight, overweight, obese, and morbidly obese.
After excluding 122 patients who were lost to follow-up and 236 patients with missing preoperative body mass index, 10,268 patients were studied. Multivariate logistic regression analyses showed that underweight was associated with higher early mortality (hazard ratio 2.63; 95% confidence interval: 1.13 to 6.11, p = 0.025). Multivariate Cox regression analyses did reveal morbid obesity as an independent predictor of late mortality (hazard ratio 1.67, 95% confidence interval: 1.15 to 2.43, p = 0.007).
Among patients undergoing isolated CABG, underweight is an independent predictor for early mortality, and morbid obesity is an independent predictor for late mortality.
肥胖对冠状动脉旁路移植术（CABG）后长期结果的影响仍存在争议。我们分析了单中心接受 CABG 手术患者的数据，以确定体重指数与合并症结合对早期和晚期死亡率的预测价值。
确定 1998 年 1 月至 2007 年 12 月期间连续接受单纯 CABG 的患者的早期和晚期死亡率。根据术前体重指数，患者被分为五组：体重不足、正常体重、超重、肥胖和病态肥胖。
排除 122 例失访患者和 236 例术前体重指数缺失患者后，共研究了 10268 例患者。多变量逻辑回归分析显示，体重不足与早期死亡率升高相关（危险比 2.63；95%置信区间：1.13 至 6.11，p = 0.025）。多变量 Cox 回归分析确实显示病态肥胖是晚期死亡率的独立预测因素（危险比 1.67，95%置信区间：1.15 至 2.43，p = 0.007）。
在接受单纯 CABG 的患者中，体重不足是早期死亡率的独立预测因素，病态肥胖是晚期死亡率的独立预测因素。
