GKD Anest Yoð Bak Dern Derg. 2020; 26(3): 165-171 | DOI: 10.5222/GKDAD.2020.40316

Impact of High Body Mass Index on Morbidity and Mortality ýn Cardiac Surgery Cardiac Surgery and Obesity

Funda Gümüþ Özcan¹, Serdar Demirgan², Taner Abdullah¹, Aysýn Selcan^2
1Baþakþehir Çam And Sakura City Hospital, Department Of Anesthesiology And Reanimation, Republic Of Turkey Ministry Of Health, Ýstanbul, Turkey
²Baðcýlar Education And Research Hospital, Department Of Anesthesiology And Reanimation, Republic Of Turkey Ministry Of Health, Science, Istanbul, Turkey

INTRODUCTION: In this study, we evaluated the effects of body mass index on mortality and morbidity after cardiac surgery.
METHODS: The record of 813 patients who performed open-heart surgery in our clinic were retrospectively analyzed. 505 patients with complete records were included in the study. Postoperative mortality and morbidity developments were compared in patients with a body mass index of (BMI) ≥30 kg/㎡ and BMI ≤30 kg/㎡ from the records.
RESULTS: 389 (%70) of patients were BMI < 30 kg/㎡, non-obese (Group N), 166 of them were BMI ≥30 kg/㎡, obese (Group OB). The mean age of groups (59.2±12.5, 59.6±9.6 years, respectively, p = 0.65) was similar. Female gender, Diabetes Mellitus (DM), hypertension, hyperlipidemia were more common in Group OB (p<0.05). Intraoperative cardiopulmonary bypass (101±43, 98±42 p=0.26) and the duration of aortic cross clamp (64±32.7, 61.6±32.5 p=0.21) were similar. Post-operative complications of pulmonary (%19, %10) and renal (%13, %9) were significantly higher in Group OB (p<0.05), tamponade (%3.1, %0.6) and bleeding revision (%5.7, %1.8) were higher in Group N (p<0.05). Mortality occurred in 27 (5%) patients after surgery. There was no significant difference between mortality rates, ICU and hospital stay (p <0.05).
DISCUSSION AND CONCLUSION: High BMI (≥30 kg/㎡) is associated with respiratory system and renal complications after cardiac surgery, and low BMI(< 30 kg/㎡) is associated with morbidities such as tamponade and bleeding revision.

Keywords: Cardiovascular Surgery, Body Mass Index, Obesity, Morbidity, Mortality

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Kalp Cerrahisinde Yüksek Vücut Kitle Ýndeksinin Morbidite ve Mortalite Üzerine Etkileri

Funda Gümüþ Özcan¹, Serdar Demirgan², Taner Abdullah¹, Aysýn Selcan^2
1TC Saðlýk Bakanlýðý Baþakþehir Çam Ve Sakura Þehir Hastanesi, Anesteziyoloji Ve Reanimasyon Kliniði, Ýstanbul, Türkiye
²Saðlýk Bilimleri Üniversitesi Baðcýlar Eðitim Ve Araþtýrma Hastanesi, Anesteziyoloji Ve Reanimasyon Kliniði, Ýstanbul, Türkiye

GÝRÝÞ ve AMAÇ: Bu çalýþmada, vücut kitle indeksinin (VKÝ) kardiyak cerrahi sonrasý mortalite ve morbidite üzerine etkilerini deðerlendirdik.
YÖNTEM ve GEREÇLER: Kliniðimizde açýk kalp cerrahisi geçiren 813 hastanýn kayýtlarý retrospektif olarak incelendi. Kayýtlarý eksiksiz olan 555 hasta çalýþmaya dahil edildi. Kayýtlardan vücut kitle indeksi (VKÝ) ≥ 30 kg/m2 ve VKÝ < 30kg/m2 olan hastalarda postoperatif mortalite ve morbidite geliþimleri karþýlaþtýrýldý.
BULGULAR: Hastalarýn 389’u (%70) VKÝ< 30kg/m2 obez olmayan (Grup N), 166’sý VKÝ ≥ 30 kg/m2 obez (Grup OB) idi. Gruplarýn yaþ ortalamalarý (sýrasýyla 59.2±12.5, 59.6±9.6 yýl p=0.65) benzerdi. Kadýn cinsiyet, diabetes mellitus, hipertansiyon, hiperlipidemi Grup OB’de fazla bulundu (p< 0.05). Ýntraoperatif kardiyopulmoner baypas (101±43, 98±42 p=0.26), aort kros klemp (64±32.7, 61.6±32.5 p=0.21) süreleri benzerdi. Postoperatif pulmoner (%19, %10), renal (%13, %9) komplikasyonlar Grup OB’de anlamlý þekilde fazlayken (p<0.05), tamponad (%3.1, %0.6) ve kanama revizyonu (%5.7, %1.8) Grup N’de daha fazla bulundu (p<0.05). Ameliyat sonrasý 27 (%5) hastada mortalite görüldü. Mortalite oranlarý, yoðun bakým ve hastane kalýþ süreleri arasýnda istatistiksel anlamlý fark tespit edilmedi (p<0.05).
TARTIÞMA ve SONUÇ: Obezite, kalp cerrahisi sonrasý solunum sistemi ve renal komplikasyonlarla, düþük vücut aðýrlýðý ise tamponad ve kanama revizyonu gibi morbiditelerle iliþkilidir.

Anahtar Kelimeler: Kalp cerrahisi, Vücut Kitle Ýndeksi, Obezite, Morbidite, Mortalite

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