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体重指数与行冠状动脉旁路移植术加瓣膜置换术患者的术后死亡率:一项回顾性队列研究。

Body mass index and postoperative mortality in patients undergoing coronary artery bypass graft surgery plus valve replacement: a retrospective cohort study.

机构信息

The Lu'an Hospital Affiliated to Anhui Medical University, Lu'an, Anhui, China.

The Lu'an People's Hospital, Lu'an, Anhui, China.

出版信息

PeerJ. 2022 Jun 14;10:e13601. doi: 10.7717/peerj.13601. eCollection 2022.

Abstract

BACKGROUND

The relationship between body mass index (BMI) and postoperative mortality in patients who undergo coronary artery bypass graft (CABG) surgery plus valve replacement is uncertain. We aimed to investigate the association between body mass index (BMI) and postoperative mortality among patients who simultaneously underwent both CABG surgery plus valve replacement.

METHODS

We retrospectively analyzed 1976 patients who underwent CABG surgery at our hospital between January 2017 and April 2021, including 202 patients who underwent valve replacement surgery during the same period. We analyzed the relationship between BMI and postoperative mortality. The relationship between BMI and postoperative mortality was assessed using smooth curve fitting and a Multiple logistic regression model.

RESULTS

The results of smoothing curve fitting showed that BMI and postoperative mortality had a non-linear relationship, and the resulting curve exhibited a two-stage change and a breakpoint. Postoperative mortality is higher in patients that have a body mass index above 25 kg/m compared to patients having a body mass index between 18 and 25 kg/m.

CONCLUSIONS

Our study found a non-linear relationship between BMI and postoperative mortality in patients undergoing CABG plus valve replacement after adjusting for potential confounders. The causal relationship between BMI and postoperative mortality still requires further investigations.

摘要

背景

体重指数(BMI)与行冠状动脉旁路移植术(CABG)加瓣膜置换术患者术后死亡率之间的关系尚不确定。我们旨在探讨同时行 CABG 加瓣膜置换术患者的 BMI 与术后死亡率之间的关系。

方法

我们回顾性分析了 2017 年 1 月至 2021 年 4 月期间在我院行 CABG 手术的 1976 例患者,其中 202 例患者同期行瓣膜置换术。我们分析了 BMI 与术后死亡率之间的关系。使用平滑曲线拟合和多因素逻辑回归模型评估 BMI 与术后死亡率之间的关系。

结果

平滑曲线拟合结果表明,BMI 与术后死亡率呈非线性关系,所得曲线呈两阶段变化且存在拐点。与 BMI 在 18 至 25kg/m2 之间的患者相比,BMI 超过 25kg/m2 的患者术后死亡率更高。

结论

本研究在调整了潜在混杂因素后发现,CABG 加瓣膜置换术后患者的 BMI 与术后死亡率之间呈非线性关系。BMI 与术后死亡率之间的因果关系仍需进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7112/9205315/dd2eb27204d5/peerj-10-13601-g001.jpg

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