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Original Articles: Adult Cardiac

Effect of Body Mass Index on Early and Late Mortality After Coronary Artery Bypass Grafting

^a Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, the Netherlands
^b Department of Anesthesiology, Catharina Hospital—Brabant Medical School, Eindhoven, the Netherlands
^c University Hospital Ghent, Ghent, Belgium
^d Department of Education and Research, Catharina Hospital, Eindhoven, the Netherlands
^e Department of Medical Psychology, Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, the Netherlands
^f Department of Anesthesiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois

Accepted for publication September 21, 2009.

^_* Address correspondence to Dr Soliman Hamad, Department of Cardiothoracic Surgery, Catharina Hospital, Michelangelolaan 2, Postbus 1350, Eindhoven, 5602 ZA, the Netherlands (Email: aasmsn{at}cze.nl).

Background: The effect of obesity on the long-term outcome after coronary artery bypass graft surgery (CABG) remains controversial. We analyzed data of patients undergoing CABG in a single center, to determine the predictive value of body mass index in combination with comorbidities on early and late mortality.

Methods: Early and late mortality of consecutive patients undergoing isolated CABG from January 1998 until December 2007 were determined. Patients were classified into five groups according to preoperative body mass index: underweight, normal weight, overweight, obese, and morbidly obese.

Results: After excluding 122 patients who were lost to follow-up and 236 patients with missing preoperative body mass index, 10,268 patients were studied. Multivariate logistic regression analyses showed that underweight was associated with higher early mortality (hazard ratio 2.63; 95% confidence interval: 1.13 to 6.11, p = 0.025). Multivariate Cox regression analyses did reveal morbid obesity as an independent predictor of late mortality (hazard ratio 1.67, 95% confidence interval: 1.15 to 2.43, p = 0.007).

Conclusions: Among patients undergoing isolated CABG, underweight is an independent predictor for early mortality, and morbid obesity is an independent predictor for late mortality.

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