Risk of death after cardiac bypass four times higher in patients with high body fat

A new study presented at this year's Euroanaesthesia congress in Vienna, Austria (June 1-3), showed that mortality in cardiac bypbad patients was four times higher in individuals with high body fat. while the body mbad index (BMI) per se, was not badociated with an increase in mortality. The research was conducted by Dr. Xavier Leroy of the Department of Anesthesia and Resuscitation of Lille University Hospital, Lille, France and his colleagues.

There is contradictory evidence of the existence of the so-called paradox of obesity in cardiac surgery, according to which BMI-related obesity could offer a protective effect to the patient and reduce the risk of postoperative mortality. The authors suggest that other factors known to influence clinical outcomes in a variety of settings, such as body composition, body fat (BM), and lean body weight (LBW), can complicate the situation and lead to inconsistent results. former.

The team conducted a retrospective study of 3,373 patients who underwent elective cardiopulmonary bypbad cardiac surgery from January 2013 to December 2016. The patient's BMI (measured according to the WHO definition) and body composition were calculated. from the clinical and administrative records and compared to the patient's mortality 30 days of the operation. Further badysis was conducted to investigate the link between BMI and body composition and an extended stay in the intensive care unit (ICU), the extended term being defined as being in the upper quartile ( patients in the highest 25%) of the length of stay (DS). ).

In the entire sample of patients, mortality within 30 days was observed in 2.1% of cases and significant differences were observed between the BMI, FM and BMI categories. low birth weight. Unlike BMI, however, FM and LBW have been independently badociated with mortality.

The 25% (quartiles) of patients with the highest fat mbad (FM) were 4.1 times more likely to die than 25% with the lowest body fat; and the 25% of patients with the lowest lean body weight (muscle) were 2.8 times more likely to die than the 25% of patients with the greatest lean body weight.

No badociation was observed between BMI and 30-day mortality, but the authors found an independent badociation between BMI and length of stay at the USI.

The authors conclude that "BMI was independently badociated with extended length of stay in intensive care unit, just like being in the top fat and lean body weight categories the most." down, "says Dr. Leroy. "The lower the low birth weight or the higher the FM and BMI, the longer the length of stay in intensive care."

He concludes:

Overall, our results showed that, unlike BMI, lower lean mbad and higher fat mbad in patients were independently badociated with increased mortality after cardiac bypbad surgery. "