June 13, 2016
2 min read

Severe obesity triples infection risk in patients undergoing CABG

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Patients with severe obesity who undergo CABG are three times more likely to experience postoperative infections than those of normal weight, according to study data published in the Journal of the American Heart Association.

Severe obesity also was associated with increased length of hospital stay after CABG.

“... It appears that addressing infection risk might be an effective strategy to decrease the length of stay for [these] patients ...,” Mary Forhan, PhD, assistant professor, department of occupational therapy, faculty of rehabilitation medicine, University of Alberta, Edmonton, Canada, said in a press release.

Mary Forhan

According to the CDC, 70% of Americans aged at least 20 years are considered overweight or obese, and 400,000 Americans undergo CABG yearly.

The study population was an ethnically and racially diverse group of 7,560 patients who had CABG in Edmonton, Canada, between April 2003 and March 2014. Patients were stratified according to BMI: normal weight (18.5-24.9 kg/m2; 20%), overweight (25-29.9 kg/m2; 40.7%), obesity class I (30-34.9 kg/m2; 25.7%), obesity class II (35-39.9 kg/m2; 9.2%) and obesity class III, defined as severe obesity ( 40 kg/m2; 4.4%).

Forhan and colleagues analyzed the associations between the overweight and obesity categories with rates of operative mortality, overall early complications, complications from infection, complications from renal issues, complications from pulmonary issues and length of stay.

Patients with severe obesity faced triple the risk for infection (OR = 3.29; 95% CI, 2.3-4.71) compared with patients with normal weight. Those in obesity class I (OR = 1.6; 95% CI, 1.24-2.05) and obesity class II (OR = 2.34; 95% CI, 1.73-3.17) also had elevated risk for infection. Patients with severe obesity also were at higher risk for overall complications from the surgery (OR = 1.56; 95% CI, 1.21-2.01) as were those in obesity class II (OR = 1.35; 95% CI, 1.11-1.63) compared with patients with normal weight.

There was no significant difference in mortality among the BMI classes.

Those with severe obesity also had longer median length of stay compared with patients with normal weight (7 vs. 6 days; P = .026).

The researchers also found that patients with severe obesity and diabetes faced hospital stays 3.2 (95% CI, 2.6-4.1) times longer than those without either condition.

“We know that wound healing in general is affected by poorly controlled glucose levels, and that adipose tissue may take longer to recover from trauma,” Forhan said in the release. “... Efforts to ensure good glycemic control for patients with diabetes pre- and post-bypass are important.” – by James Clark

Disclosure: The researchers report no relevant financial disclosures.