Costa Vinícius Eduardo Araújo, Ferolla Silvia Marinho, Reis Tâmara Oliveira dos, Rabello Renato Rocha, Rocha Eduardo Augusto Victor, Couto Célia Maria Ferreira, Couto José Carlos Ferreira, Bento Alduir
Hospital Vera Cruz, Belo Horizonte, MG, BR.
Rev Bras Cir Cardiovasc. 2015 Jul-Sep;30(3):335-42. doi: 10.5935/1678-9741.20150027.
This study aimed to analyze the impact of body mass index on outcomes of 101 patients undergoing coronary artery bypass grafting, valve replacement, or combined valve/ coronary artery bypass grafting surgery in a private hospital in Belo Horizonte, Brazil.
This was a prospective cross-sectional study of patients undergoing cardiac surgery from May 2009 to December 2012. All patients were followed up from the first day of admission until discharge or death. Patients were divided into three groups according to BMI: normal weight, overweight, and obese. The main outcome measure was the association between BMI and postoperative morbidities and mortality.
Multivariate analysis identified obesity as an independent predictor of increased risk of surgical reintervention (odds ratio [OR] 13.6; 95%CI 1.1 - 162.9; P=0.046) and reduced risk of bleeding (OR 0.05; 95% CI 0.09 - 0.69; P=0.025). Univariate analysis showed that obesity was associated with increased frequency of wound dehiscence (P=0.021). There was no association between BMI and other complications or mortality in univariate analysis. There was also no association between body mass index and duration of cardiopulmonary bypass, aortic clamping, mechanical ventilation, and intensive care unit or hospital stay.
Obese individuals undergoing coronary artery bypass grafting, valve replacement, or combined surgery have a higher postoperative risk of surgical reintervention and lower chances of bleeding.
本研究旨在分析体重指数对巴西贝洛奥里藏特一家私立医院101例接受冠状动脉搭桥术、瓣膜置换术或瓣膜/冠状动脉搭桥联合手术患者预后的影响。
这是一项对2009年5月至2012年12月接受心脏手术患者的前瞻性横断面研究。所有患者从入院第一天起直至出院或死亡均接受随访。患者根据体重指数分为三组：正常体重、超重和肥胖。主要结局指标是体重指数与术后发病率和死亡率之间的关联。
多变量分析确定肥胖是手术再次干预风险增加的独立预测因素（比值比[OR]13.6；95%置信区间1.1 - 162.9；P = 0.046）以及出血风险降低（OR 0.05；95%置信区间0.09 - 0.69；P = 0.025）。单变量分析显示肥胖与伤口裂开频率增加相关（P = 0.021）。在单变量分析中，体重指数与其他并发症或死亡率之间无关联。体重指数与体外循环时间、主动脉阻断时间、机械通气时间以及重症监护病房或住院时间之间也无关联。
接受冠状动脉搭桥术、瓣膜置换术或联合手术的肥胖个体术后手术再次干预风险较高，出血几率较低。
