Document Detail


The effect of obesity on mid-term survival following coronary artery bypass surgery.
MedLine Citation:
PMID:  12614808     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Several studies have shown no significantly increased risk of in-hospital mortality for obese patients after coronary artery bypass grafting (CABG). However, the effect of obesity on mid-term survival has not been adequately studied. We set out to examine whether mid-term survival following CABG is affected by obesity. METHODS: We performed a retrospective study of 4713 consecutive patients undergoing isolated CABG between April 1997 and September 2001. Body mass index (BMI) was used as the measure of obesity, with 3429 patients categorised as non-obese (BMI<30 kg/m(2)), and 1284 patients as obese (BMI> or = 30 kg/m(2)). Patient records were linked to the National Strategic Tracing Service, which records all deaths in the community, to establish current vital status. Deaths occurring over time were described using Kaplan-Meier techniques. To control for differences in patient characteristics, we used Cox proportional hazards analysis to calculate adjusted hazard ratios (HR) and 95% confidence intervals (CI). RESULTS: Three hundred and thirty (7.0%) deaths occurred during the study period, with a mean follow-up of 2.4+/-1.4 years. The crude HR of mid-term mortality for obese patients was 1.09 (95% CI 0.86-1.39; P=0.457). After adjustment for core pre-operative factors, the adjusted HR of mid-term mortality for obese patients was 1.28 (95% CI 1.01-1.64; P=0.048). The adjusted freedom from death in the obese patients at 30 days, 1, 2, 3, and 4 years was 97.9, 95.9, 94.2, 92.4 and 90.5%, respectively, compared with 98.4, 96.8, 95.5, 94.0 and 92.5% for the non-obese patients. CONCLUSIONS: Although in-hospital mortality after CABG does not seem to be adversely affected by obesity there appears to be a significant increase in mortality in obese patients during a 4-year follow-up period.
Authors:
Manoj Kuduvalli; Antony D Grayson; Aung Y Oo; Brian M Fabri; Abbas Rashid
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  23     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-04     Completed Date:  2003-07-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  368-73     Citation Subset:  IM    
Affiliation:
Department of Cardiothoracic Surgery,The Cardiothoracic Centre, Liverpool, UK. arashid@ccl-tr.nwest.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Aged
Body Mass Index
Coronary Artery Bypass / mortality*
England / epidemiology
Epidemiologic Methods
Female
Humans
Male
Medical Record Linkage
Middle Aged
Obesity / complications*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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