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The effects of body mass index on outcomes for patients undergoing surgical aortic valve replacement

Authors: Keir Forgie; Sabin J. Bozso; Yongzhe Hong; Colleen M. Norris; Abdullah Ishaque; Richdeep S. Gill; Darren H. Freed; +3 Authors

The effects of body mass index on outcomes for patients undergoing surgical aortic valve replacement

Abstract

Abstract Background Most of the studies of obesity and postoperative outcome have looked predominantly at coronary artery bypass grafting with fewer focused on valvular disease. The purpose of this study was to compare the outcomes of patients undergoing aortic valve replacement stratified by body mass index (BMI, kg/m^2). Methods The Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease registry captured 4780 aortic valve replacements in Alberta, Canada from January 2004 to December 2018. All recipients were stratified by BMI into five groups (BMI: < 20, 20–24.9, 25–29.9, 30–34.9, and > = 35). Log-rank test and Cox regression were used to examine the crude and adjusted survival differences. Results Intra-operative clamp time and pump time were similar among the five groups. Significant statistical differences between groups existed for the incidence of isolated AVR, AVR and CABG, hemorrhage, septic infection, and deep sternal infection (p < 0.05). While there was no significant statistical difference in the mortality rate across the BMI groups, the underweight AVR patients (BMI < 20) were associated with increased hazard ratio (1.519; 95% confidence interval: 1.028–2.245) with regards to all-cause mortality at the longest follow-up compared with normal weight patients. Conclusion Overweight and obese patients should be considered as readily for AVR as normal BMI patients.

Country
Canada
Related Organizations
Keywords

Adult, Male, Survival, Databases, Factual, Obesity (incl related subjects), Aortic Valve Insufficiency, Operative Time, Risk Assessment, Alberta, Body Mass Index, Postoperative Complications, Outcomes (incl mortality, Risk Factors, Diseases of the circulatory (Cardiovascular) system, Humans, Obesity, Heart (incl related subjects), Aged, Retrospective Studies, Aged, 80 and over, Heart Valve Prosthesis Implantation, Aortic Valve Stenosis, Middle Aged, Aortic valve replacement, RC666-701, Aortic Valve, Female, Morbidity, Research Article

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    citations
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    15
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Average
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
15
Top 10%
Average
Top 10%
Green
gold