TY - JOUR
T1 - Obesity
T2 - An independent predictor of in-hospital postoperative renal insufficiency among patients undergoing cardiac surgery?
AU - Virani, Salim S.
AU - Nambi, Vijay
AU - Lee, Vei Vei
AU - Elayda, MacArthur A.
AU - Pan, Wei
AU - Petersen, Laura A.
AU - Wilson, James M.
AU - Willerson, James T.
AU - Ballantyne, Christie M.
N1 - Funding Information:
This work was partially funded by the ANR national research program DOTS (ANR- 06-SETI-003).
Funding Information:
★ This work was partially funded by the ANR national research program DOTS (ANR-06-SETI-003).
PY - 2009
Y1 - 2009
N2 - We sought to determine, retrospectively, whether obesity was associated with adverse renal outcomes in 17,630 patients who underwent cardiac surgery from January 1995 through December 2006. Obesity was defined as a body mass index ≥30 kg/m2. The primary outcome was any episode of postoperative renal insufficiency (requiring or not requiring dialysis) before hospital discharge. Outcomes were evaluated in the entire cohort and in subgroups undergoing isolated coronary artery bypass grafting (CABG), isolated valve surgery, and combined CABG and valve surgery. The final analysis included 16,429 patients, 5,124 (31%) of whom were obese. In the entire cohort, obesity was associated both with increased risk of any postoperative renal insufficiency (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.21-1.55) and with increased risk of renal insufficiency not requiring dialysis (OR, 1.41; 95% CI, 1.23-1.62). Obesity was associated with an increased risk of postoperative renal insufficiency in patients undergoing isolated CABG (OR, 1.38; 95% CI, 1.18-1.61), isolated valve surgeries (OR, 1.39; 95% CI, 1.05-1.85), and combined CABG and valve surgeries (OR, 1.35; 95% CI, 0.99-1.83; statistically nonsignificant). Development of postoperative renal insufficiency was associated with a significantly higher mortality rate (P <0.0001) and with a significantly longer hospital stay (23 vs 10.5 days; P <0.0001). We conclude that obesity is associated with a significant increase in postoperative renal insufficiency in cardiac surgery patients, an effect that we attribute to an increase in postoperative renal failure that does not require dialysis.
AB - We sought to determine, retrospectively, whether obesity was associated with adverse renal outcomes in 17,630 patients who underwent cardiac surgery from January 1995 through December 2006. Obesity was defined as a body mass index ≥30 kg/m2. The primary outcome was any episode of postoperative renal insufficiency (requiring or not requiring dialysis) before hospital discharge. Outcomes were evaluated in the entire cohort and in subgroups undergoing isolated coronary artery bypass grafting (CABG), isolated valve surgery, and combined CABG and valve surgery. The final analysis included 16,429 patients, 5,124 (31%) of whom were obese. In the entire cohort, obesity was associated both with increased risk of any postoperative renal insufficiency (odds ratio [OR], 1.37; 95% confidence interval [CI], 1.21-1.55) and with increased risk of renal insufficiency not requiring dialysis (OR, 1.41; 95% CI, 1.23-1.62). Obesity was associated with an increased risk of postoperative renal insufficiency in patients undergoing isolated CABG (OR, 1.38; 95% CI, 1.18-1.61), isolated valve surgeries (OR, 1.39; 95% CI, 1.05-1.85), and combined CABG and valve surgeries (OR, 1.35; 95% CI, 0.99-1.83; statistically nonsignificant). Development of postoperative renal insufficiency was associated with a significantly higher mortality rate (P <0.0001) and with a significantly longer hospital stay (23 vs 10.5 days; P <0.0001). We conclude that obesity is associated with a significant increase in postoperative renal insufficiency in cardiac surgery patients, an effect that we attribute to an increase in postoperative renal failure that does not require dialysis.
KW - Body mass index
KW - Cardiac surgical procedures/adverse effects
KW - Cardiopulmonary bypass/adverse effects
KW - Inflammation/complications
KW - Kidney failure/etiology
KW - Obesity/complications
KW - Oxidative stress
KW - Postoperative complications
KW - Retrospective studies
KW - Risk factors
KW - Systemic inflammatory response syndrome
KW - Treatment outcome
UR - http://www.scopus.com/inward/record.url?scp=76149091170&partnerID=8YFLogxK
M3 - Article
C2 - 20069078
AN - SCOPUS:76149091170
SN - 0730-2347
VL - 36
SP - 540
EP - 545
JO - Texas Heart Institute Journal
JF - Texas Heart Institute Journal
IS - 6
ER -