Department of Anesthesiology, Hohhot First Hospital, Hohhot, 010030, Inner Mongolia Autonomous Region, China.
Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, No. 167, Beilishi Road, Xicheng District, Beijing, 100037, China.
J Cardiothorac Surg. 2024 Feb 11;19(1):86. doi: 10.1186/s13019-024-02586-1.
This study is designed to investigate the impact of body mass index (BMI) on the short-term outcomes of patients undergoing off-pump coronary artery bypass graft (OPCAB) surgery.
Data was obtained from 1006 Chinese patients who underwent isolated, primary OPCAB at a high-traffic cardiovascular center during 2020. Subjects were categorized, by BMI, into a low & normal weight (LN) group (BMI < 24 kg/m), an overweight (OVW) group (24 ≤ BMI < 28 kg/m), and an obese (OBS) group (BMI ≥ 28 kg/m). Information pertaining to patients' short-term outcomes (including incidence of mortality and morbidities; duration of postoperative mechanical ventilation; length of stay in the ICU and hospital; postoperative bleeding; etc.) were extracted, and the data from each group were compared.
The incidences of in-hospital mortality and morbidities were similar for all three groups. The volume of fluid infusion, postoperative bleeding within 24 h and total bleeding in LN group were higher than those in the OBS group (P < 0.001). The hemoglobin level was lower in the LN group than that in the OBS group (P < 0.001). Duration of mechanical ventilation and length of stay in the ICU in the LN group were longer than those in the OBS group (P < 0.001).
Our results demonstrate that BMI is not significantly related with short-term outcomes in OPCAB patients. However, we suggest that OPCAB patients with low-normal BMI are more susceptible to post-operative blood loss.
本研究旨在探讨体重指数(BMI)对非体外循环冠状动脉旁路移植术(OPCAB)患者短期结局的影响。
本研究纳入了 2020 年在一家高流量心血管中心接受单纯性 OPCAB 的 1006 例中国患者。根据 BMI 将患者分为低体重和正常体重组(BMI<24kg/m)、超重组(24≤BMI<28kg/m)和肥胖组(BMI≥28kg/m)。收集患者短期结局的相关信息(包括死亡率和发病率、术后机械通气时间、入住 ICU 和医院的时间、术后出血等),并对各组数据进行比较。
三组患者的住院死亡率和发病率相似。LN 组的输液量、术后 24 小时内出血量和总出血量均高于 OBS 组(P<0.001)。LN 组的血红蛋白水平低于 OBS 组(P<0.001)。LN 组的机械通气时间和 ICU 入住时间长于 OBS 组(P<0.001)。
我们的结果表明 BMI 与 OPCAB 患者的短期结局无显著相关性。然而,我们建议 OPCAB 患者中低正常 BMI 者更容易发生术后出血。