Impact of body mass index and albumin on morbidity and mortality after cardiac surgery
- 1 November 1999
- journal article
- conference paper
- Published by Elsevier BV in The Journal of Thoracic and Cardiovascular Surgery
- Vol. 118 (5), 866-873
- https://doi.org/10.1016/s0022-5223(99)70056-5
Abstract
Objective: Extremely thin and overly obese patients may not tolerate cardiac surgery as well as other patients, A retrospective study was conducted to determine whether the extremes of body mass index (weight/height(2) [kg/m(2)]) and/or cachexia increased the morbidity and mortality associated with cardiac operations. Methods: Body mass index was used to objectively measure "thinness" (body mass index < 20) and "heaviness" (body mass index > 30); preoperative serum albumin was used to quantify nutritional status and underlying disease. Data were gathered between 1993 and 1997 from 5168 consecutive patients undergoing coronary artery bypass or valve operations, or both. Results: No significant correlations were observed between body mass index and preoperative albumin levels, Low body mass index (<20) and low albumin level (<2.5 g/dL) were each independently associated with increased mortality after cardiopulmonary bypass (P less than or equal to .0005), Operative mortality was highest among those with both low body mass index and lowalbumin level. Multivariable logistic regression, adjusting for potentially confounding variables, demonstrated that an albumin level of less than 2.5 g/dL was independently associated with increased risk of reoperation for bleeding, postoperative renal failure, and prolonged ventilatory support, intensive care unit stay, and total length of stay, A body mass index of more than 30 was associated with increased sternal wound infection and saphenous vein harvest site infection. Conclusions: Hypoalbuminemia and low body mass index each independently predict increased morbidity and mortality after cardiac operations. Preoperative risk stratification with the use of body mass index and serum albumin may help to identify subgroups of patients at high risk for adverse outcomes after cardiac operations.Keywords
This publication has 18 references indexed in Scilit:
- Obesity and Risk of Adverse Outcomes Associated With Coronary Artery Bypass SurgeryCirculation, 1998
- Clinical Characteristics of Preoperative Hypoalbuminemia Predict Outcome of Cardiovascular SurgeryJournal of Parenteral and Enteral Nutrition, 1997
- A model that predicts morbidity and mortality after coronary artery bypass graft surgeryJournal of the American College of Cardiology, 1996
- Is body size the cause for poor outcomes of coronary artery bypass operations in women?The Journal of Thoracic and Cardiovascular Surgery, 1995
- Dose-Response and Trend Analysis in EpidemiologyEpidemiology, 1995
- Differences between men and women in hospital mortality associated with coronary artery bypass graft surgery. The Northern New England Cardiovascular Disease Study Group.Circulation, 1993
- Influence of obesity on the early and long term results of surgery for coronary artery diseaseEuropean Journal of Cardio-Thoracic Surgery, 1991
- Increased complications and prolonged hospital stay in elderly cardiac surgical patients with low serum albuminThe American Journal of Cardiology, 1989
- Regression Models in Clinical Studies: Determining Relationships Between Predictors and ResponseJNCI Journal of the National Cancer Institute, 1988
- Indices of relative weight and obesityJournal of Chronic Diseases, 1972