Ardeshiri Maryam, Faritous Zahra, Ojaghi Haghighi Zahra, Hosseini Shirin, Baghaei Ramin
Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Anesth Pain Med. 2014 May 4;4(2):e18884. doi: 10.5812/aapm.18884. eCollection 2014 May.
Recent years have witnessed the emergence of obesity as a major public health concern. The drastic rise in obesity and its concomitant co-morbidities is a reflection of the recent changes in dietary habits in Iran and many other developing countries. A recent large population study in Tehran reported that 58% and 75% of middle-aged Iranian men and women, respectively, were either overweight or obese.
Considering the impact of obesity on mortality and morbidity after coronary artery bypass graft surgery (CABG), we sought to investigate the association between central obesity and the body mass index (BMI) and the post-CABG mortality and morbidity in Iranian patients.
This prospective study was on 235 adult patients scheduled for isolated CABG in a university hospital. The patients were divided in two groups according to BMI ≥ 30 (obese; n = 60) and BMI < 30 (non-obese; n = 175). In-hospital and late (after 3 months) morbidity and mortality rates were compared between obese and non-obese patients.
A total of 235 patients (135 women) with a mean age of 59 ± 9.2 years (range = 29 to 79 years), mean BMI of 27.3 ± 4.2 (range = 17 to 40), and mean waist circumference of 101.2 ± 14.7 cm (range = 55 to 145 cm) were included. By the third postoperative month, wound infection had significantly increased in patients with BMI ≥ 30 (P = 0.022). In-hospital and late morbidity and mortality rates were comparable between the two groups (P > 0.05).
In our patients obesity was a risk factor for wound infection but not atelectasis or the need for intra-aortic balloon pump or re-exploration. Obesity was not associated with increased in-hospital or 3 months mortality rates after CABG.
近年来，肥胖已成为一个主要的公共卫生问题。肥胖及其伴随的合并症急剧增加，反映了伊朗和许多其他发展中国家近期饮食习惯的变化。德黑兰最近的一项大型人群研究报告称，伊朗中年男性和女性中分别有58%和75%超重或肥胖。
考虑到肥胖对冠状动脉搭桥手术（CABG）后死亡率和发病率的影响，我们试图研究伊朗患者中心性肥胖与体重指数（BMI）以及CABG后死亡率和发病率之间的关联。
这项前瞻性研究针对的是一家大学医院计划进行单纯CABG的235名成年患者。根据BMI≥30（肥胖；n = 60）和BMI<30（非肥胖；n = 175）将患者分为两组。比较肥胖和非肥胖患者的住院期间及晚期（3个月后）发病率和死亡率。
共纳入235例患者（135名女性），平均年龄59±9.2岁（范围 = 29至79岁），平均BMI为27.3±4.2（范围 = 17至40），平均腰围为101.2±14.7 cm（范围 = 55至145 cm）。到术后第三个月，BMI≥30的患者伤口感染显著增加（P = 0.022）。两组的住院期间及晚期发病率和死亡率相当（P>0.05）。
在我们的患者中，肥胖是伤口感染但不是肺不张、主动脉内球囊泵使用或再次手术的危险因素。肥胖与CABG后住院期间或3个月死亡率增加无关。
