Does Advanced Obesity Affect CABG Surgery Outcomes?
Batuhan Yazıcı1, Zinar Apaydın2, Mustafa Can Kaplan3, Zihni Mert Duman4, Barış Timur2, Tural Muradlı2, Hasan Coşkun2, Ersin Kadiroğulları21Department of Cardiovascular Surgery, Hatay Training and Research Hospital, Hatay, Türkiye2Department of Cardiovascular Surgery, Mehmet Akif Ersoy Chest, Heart and Vascular Surgery Training and Research Hospital, Istanbul, Türkiye
3Department of Cardiovascular Surgery, Artvin State Hospital, Artvin, Türkiye
4Department of Cardiovascular Surgery, Elazig City Hospital, Elazig, Türkiye
INTRODUCTION: Obesity has been identified as a key risk factor for coronary artery bypass grafting (CABG) surgery. This study examines the short-term effects of obesity on clinical outcomes and mortality following CABG.
METHODS: A total of 216 CABG patients were recruited and categorized into two groups according to body mass index (BMI): ≥35 kg/m² and <35 kg/m². Preoperative data included age, sex, height, weight, EuroSCORE II, diabetes mellitus (DM), hyperlipidemia (HL), chronic obstructive pulmonary disease (COPD), ejection fraction (EF), and smoking status. Postoperative outcomes included intubation time, intensive care unit (ICU) stay, wound complications, sternal separation, atrial fibrillation (AF), cerebrovascular disease (CVD), pleural effusion (PE), mortality, and reoperation.
RESULTS: Patients with BMI ≥35 kg/m² had higher rates of DM, hypertension, HL, COPD, smoking, and EuroSCORE II scores, while EF scores were lower. In this group, the durations of intubation, ICU stay, and hospital stay were longer; wound complications, sternal separation, atrial fibrillation, and pulmonary embolism were more frequent. Obesity was identified as an independent risk factor for prolonged ICU stay (OR: 5.16; 95% CI: 1.39–19.17; p=0.014). No significant difference in mortality rates was observed between the two groups.
DISCUSSION AND CONCLUSION: Although early mortality is not affected in obese patients with BMI ≥35 kg/m², the durations of intubation, ICU stay, and hospital stay are prolonged; wound healing problems, sternal separation, AF, and PE incidence are increased.
Makale Dili: İngilizce