Koroner arter bypass cerrahisi uygulanan hastalarda vücut kitle indeksinin mortalite ve morbidite üzerine etkisi
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Date
2013
Authors
Akarsu, Serkan
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Obezite, diabetes mellitus (DM), hipertansiyon (HT), strok, belirlikanser tipleri ve iskemik kalp hastalığı için risk faktörüdür. Obezite ile koronerarter hastalığı (KAH) arasında doğrusal bir ilişki bulunduğu ve erişkin çağındaorta derecede kilo alımının KAH riskini arttırdığı bilinmektedir. Obeziteinsidansının günümüzde giderek artması ve obezitenin olumsuz etkilerininbilinmesi nedeniyle koroner bypass arter greftleme (KABG) ameliyatı veobezitenin ilişkisi önemli bir tartışma konusu haline gelmiştir.Çalışmamızda, KABG uygulanan hasta nüfusunda body mass indeks(BMİ) oranlarının ameliyat mortalite ve morbiditesi üzerinde etkisi olupolmadığı araştırıldı. Uludağ Üniversitesi Tıp Fakültesi Kalp ve DamarCerrahisi'nde Eylül 2009-Ekim 2011 tarihleri arasında KABG operasyonuuygulanan 403 hasta BMİ değerlerine göre 5 gruba ayrıldılar. Hastalarınpreoperatif özellikleri, operasyon verileri ve 6 aylık izlem süresince oluşanpostoperatif komplikasyonları gruplar arasında karşılaştırıldı. Gruplardaoluşan komplikasyonlar, hastaların kardiyopulmoner bypass veya off pumpkoroner bypass yöntemi ile opere edilmesi yönünden de incelendi.Hastaların preoperatif özelliklerinden HT, miyokard infarktüsü (Mİ)öyküsü, aile öyküsü, hiperlipidemi, serebrovasküler olay öyküsü, konjestifkalp yetmezliği, DM, renal yetmezlik, sigara kullanımı, gastrointestinalhastalık yönünden gruplar arasında istatistiksel açıdan anlamlı fark yoktu.Periferik arter hastalığı (p= 0.009), ejeksiyon fraksiyonu (p=0,021) ve kronikobstruktif akciğer hastalığı (p=0,044) açısından gruplar arasında istatistikselaçıdan fark saptandı. Postoperatif komplikasyonlar açısından gruplararasında istatistiksel açıdan anlamlı fark yoktu. Meydana gelenkomplikasyonların operasyon yöntemi ile ilgisi bulunamadı. Tüm gruplarda 1aylık mortalite oranı %1.48 ve 6 aylık mortalite oranı %1,7 olarak bulundu.Bu çalışmaya göre; obezite, KABG cerrahisi sonrası mortalite vediğer olumsuz sonuçlar için bir risk artışına yol açmaz. Obezite, hastanedekalış süresini uzatabilir ve KABG maliyetini artırabilir.
Obesity is a risk factor for diabetes mellitus (DM), hypertension (HT),stroke, certain types of cancer and ischemic heart disease. It is known that,there is a linear relationship between obesity and coronary artery disease(CAD). Moderate weight gain in adulthood, increase the risk of CAD. Theincreasing incidence and because of the known adverse effects of obesity,coronary artery bypass grafting (CABG) surgery and obesity relationship hasbecome an important topic of discussion.In this study, we have investigated the effect of the body mass index(BMI) rates on mortality and morbidity, in the population of patientsundergoing CABG surgery. The 403 patients undergoing CABG surgerybetween September 2009-October 2011 in Uludag University School ofMedicine Cardiovascular Surgery were divided into 5 groups according toBMI. Preoperative characteristics, operative data, and post-operativecomplications during the follow-up of 6 months were compared between thegroups. The complications in the groups of patients were evaluated in termsof bypass surgery method.There were no statistically significant difference between the groupsaccording to preoperative characteristics, such as hypertension, history ofmyocardial infarction, family history, hyperlipidemia, history ofcerebrovascular accident, congestive heart failure, diabetes mellitus, renalfailure, smoking and gastrointestinal disease. Peripheral artery disease (p =0.009), ejection fraction (p = 0.021) and chronic obstructive pulmonarydisease (p = 0.044) were statistically different between the groups. Therewere no statistically significant difference between the groups in terms ofpost-operative complications. No relation was found between occurringcomplications and in methods of operation. In all groups, 1-month mortalityrate of 1.48% and 6-month mortality rate was found to be 1,7%.According to this study, obesity, does not lead to an increased risk onmortality and other adverse outcomes after CABG surgery. Obesity mayprolong hospital stay and increase the cost of CABG.
Obesity is a risk factor for diabetes mellitus (DM), hypertension (HT),stroke, certain types of cancer and ischemic heart disease. It is known that,there is a linear relationship between obesity and coronary artery disease(CAD). Moderate weight gain in adulthood, increase the risk of CAD. Theincreasing incidence and because of the known adverse effects of obesity,coronary artery bypass grafting (CABG) surgery and obesity relationship hasbecome an important topic of discussion.In this study, we have investigated the effect of the body mass index(BMI) rates on mortality and morbidity, in the population of patientsundergoing CABG surgery. The 403 patients undergoing CABG surgerybetween September 2009-October 2011 in Uludag University School ofMedicine Cardiovascular Surgery were divided into 5 groups according toBMI. Preoperative characteristics, operative data, and post-operativecomplications during the follow-up of 6 months were compared between thegroups. The complications in the groups of patients were evaluated in termsof bypass surgery method.There were no statistically significant difference between the groupsaccording to preoperative characteristics, such as hypertension, history ofmyocardial infarction, family history, hyperlipidemia, history ofcerebrovascular accident, congestive heart failure, diabetes mellitus, renalfailure, smoking and gastrointestinal disease. Peripheral artery disease (p =0.009), ejection fraction (p = 0.021) and chronic obstructive pulmonarydisease (p = 0.044) were statistically different between the groups. Therewere no statistically significant difference between the groups in terms ofpost-operative complications. No relation was found between occurringcomplications and in methods of operation. In all groups, 1-month mortalityrate of 1.48% and 6-month mortality rate was found to be 1,7%.According to this study, obesity, does not lead to an increased risk onmortality and other adverse outcomes after CABG surgery. Obesity mayprolong hospital stay and increase the cost of CABG.
Description
Keywords
KABG, Obezite, BMİ, Mortalite, Morbidite, CABG, Obesity, BMI, Mortality, Morbidity
Citation
Akarsu, Serkan (2013). Koroner arter bypass cerrahisi uygulanan hastalarda vücut kitle indeksinin mortalite ve morbidite üzerine etkisi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.