当前位置： SCI文献检索 > ANESTHESIOLOGY期刊下所有文献 > Obesity in diabetic patients undergoing coronary artery bypass graft surgery is associated with increased postoperative morbidity.

Obesity in diabetic patients undergoing coronary artery bypass graft surgery is associated with increased postoperative morbidity.

Abstract：

BACKGROUND:Despite the fact that obesity is a known risk factor for cardiovascular disease, many studies have failed to demonstrate that obesity is independently associated with an increased risk of cardiovascular morbidity and mortality in nondiabetic patients undergoing coronary artery bypass graft surgery. The authors investigated the influence of obesity on adverse postoperative outcomes in diabetic and nondiabetic patients after primary coronary artery bypass surgery. METHODS:A retrospective cohort study of patients undergoing primary coronary artery bypass surgery (n = 9,862) between January 1995 and December 2004 at the Texas Heart Institute was performed. Diabetic (n = 3,374) and nondiabetic patients (n = 6,488) were classified into five groups, according to their body mass index: normal weight (n = 2,148), overweight (n = 4,257), mild obesity (n = 2,298), moderate obesity (n = 785), or morbid obesity (n = 338). Multivariate, stepwise logistic regression was performed controlling for patient demographics, medical history, and preoperative medications to determine whether obesity was independently associated with an increased risk of adverse postoperative outcomes. RESULTS:Obesity in nondiabetic patients was not independently associated with an increased risk of adverse postoperative outcomes. In contrast, obesity in diabetic patients was independently associated with a significantly increased risk of postoperative respiratory failure (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.41-3.61; P < 0.001), ventricular tachycardia (OR, 2.27; 95% CI, 1.18-4.35; P < 0.02), atrial fibrillation (OR, 1.56; 95% CI, 1.03-2.38; P < 0.04), atrial flutter (OR, 2.38; 95% CI, 1.29-4.40; P < 0.01), renal insufficiency (OR, 1.66; 95% CI, 1.10-3.41; P < 0.03), and leg wound infection (OR, 5.34; 95% CI, 2.27-12.54; P < 0.001). Obesity in diabetic patients was not independently associated with an increased risk of mortality, stroke, myocardial infarction, sepsis, or sternal wound infection. CONCLUSION:Obesity in diabetic patients is an independent predictor of worsened postoperative outcomes after primary coronary artery bypass graft surgery.

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

Pan W,Hindler K,Lee VV,Vaughn WK,Collard CD

doi

10.1097/00000542-200603000-00010

subject

Has Abstract

pub_date

2006-03-01 00:00:00

pages

441-7

issue

eissn

0003-3022

issn

1528-1175

pii

00000542-200603000-00010

journal_volume

104

pub_type

杂志文章

在线工具

Obesity in diabetic patients undergoing coronary artery bypass graft surgery is associated with increased postoperative morbidity.