Effect of Body Mass Index on Postoperative Complications in Beating Coronary Artery Surgery

Abstract

BACKGROUND: Body Mass Index (BMI) is considered as an important risk factor in cardiovascularsurgery. We designed a historical cohort study for the evaluation of perioperative complications relatedto BMI in patients who underwent off-pump coronary artery bypass grafting (OPCAB).METHODS: We studied 1120 consecutive patients who underwent OPCAB between January 2008 andDecember 2011 in Imam Ali Hospital, Kermanshah, Iran. Patients were divided into four groupsaccording to BMI: underweight/low BMI (< 18.5 kg/m 2 ), healthy weight (between 18.5 kg/m 2 and 24.9kg/m 2 ), overweight/high BMI (between 25 kg/m 2 and 30 kg/m 2 ), and obese/very high BMI (> 30 kg/m 2 ).RESULTS: In multivariable regression analysis, an important correlation between the underweight/lowBMI group and mortality was observed (p=0.037). Postoperative stroke, postoperative atrial fibrillation(AF) and intra-aortic balloon pump (IABP) use were not associated with BMI. In linear regressionanalysis, significant correlations between low BMI, reintubation, ICU stay time and intubation time werefound. Re-exploration for bleeding was significantly correlated with having a low or high BMI.CONCLUSION: Having a low BMI (which is association with malnutrition and respiratory musclesweakness) was significantly associated with reintubation, prolonged intubation time and ICU stay time.The obese group was also associated with postoperative atelectasia and fever.