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Cardiac surgery in patients with body mass index of 50 or greater.

Villavicencio, MA; Sundt, TM; Daly, RC; Dearani, JA; McGregor, CGA; Mullany, CJ; Orszulak, TA; ... Schaff, HV; + view all (2007) Cardiac surgery in patients with body mass index of 50 or greater. Ann Thorac Surg , 83 (4) pp. 1403-1411. 10.1016/j.athoracsur.2006.10.076.

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Abstract

BACKGROUND: The seemingly inexorable rise in obesity worldwide is creating a new set of challenges for healthcare providers. Demand for cardiac surgical intervention among patients at extreme levels of obesity (body mass index [BMI] > or = 50) is increasing; however, the risks, benefits, and resources required to meet this need have not been established. METHODS: Between 1993 and 2004, 57 patients with a BMI of 50 or more underwent cardiac surgical procedures at our institution. The mean BMI was 54 +/- 4, weight range was 124 to 226 kg. The mean age of the study group was 55 +/- 12 years, and comorbidities included diabetes mellitus in 29 (51%), hypertension in 40 (70%), hyperlipidemia in 22 (39%), and obstructive sleep apnea in 16 (28%). RESULTS: The operative mortality was 7% (4 patients). Eleven patients (20%) required prolonged intubation (more than 24 hours), and mean intensive care unit stay was 5 +/- 9 days. Wound complications requiring surgery occurred in 3 (5%). Survival at 1 and 5 years was 93% +/- 4% and 76 +/- 8%, respectively. By univariate analysis, age and endocarditis were associated with long-term mortality and major perioperative complications. As a dichotomous variable, BMI greater than 54 was a significant predictor of renal failure and prolonged mechanical ventilation. CONCLUSIONS: Cardiac surgery in the patient with a BMI of 50 or greater is associated with significant resource utilization, including prolonged intensive care unit and hospital stay, with prolonged intubation and wound complications relatively common.

Type: Article
Title: Cardiac surgery in patients with body mass index of 50 or greater.
Location: Netherlands
DOI: 10.1016/j.athoracsur.2006.10.076
Keywords: Adult, Aged, Analysis of Variance, Body Mass Index, Cardiac Surgical Procedures, Cause of Death, Confidence Intervals, Coronary Artery Bypass, Female, Follow-Up Studies, Heart Valve Prosthesis Implantation, Humans, Intraoperative Complications, Length of Stay, Male, Middle Aged, Obesity, Morbid, Postoperative Care, Postoperative Complications, Probability, Retrospective Studies, Risk Assessment, Survival Analysis, Treatment Outcome
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Cardiovascular Science > Pre-clinical and Fundamental Science
URI: http://discovery.ucl.ac.uk/id/eprint/1373706
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