Araştırma Makalesi
BibTex RIS Kaynak Göster

Comparison of Obese and Morbidly Obese Patients Underwent Coronary Artery Bypass Graft Operations

Yıl 2018, , 890 - 899, 15.08.2018
https://doi.org/10.30569/adiyamansaglik.435696

Öz

Aim: Obesity and morbid obesity threatens society as a major public health problem in developing countries. However, for many obese or morbidly obese patients, coronary artery bypass grafting operation is needed due to coronary artery disease. In this study, we aimed to evaluate the risk factors which increase mortality and morbidity in these obese and morbidly obese patients underwent coronary artery bypass grafting in our clinic.

Materials and methods: Obese and morbidly obese patients underwent coronary artery bypass grafting due to coronary artery disease in our clinic between 2008 and 2014 were analyzed retrospectively. 593 patients underwent coronary artery bypass grafting between the years specified. They were divided into two groups as obese (n=69) and morbid obese (n=68) patient. Each morbid obese patients has a body mass index more than 35 kg/m2 and a body surface area more than 2.0 kg/m2. Each obese patients has a body mass indexes between 25-35 kg/m2 and a body surface area between 1.8-2.0 kg/m2. 

Results: The median age of the patients was 61,20±9.04 in the obese patient group and  60,54±10,65 in morbid obese patient group. Diabetes mellitus was present in 32(46,4%) patients in obese patient group, and in 20( 29,4%) patients in  morbid obese patient group (p=0.041). The number of patients with complaints of chest pain was 20(29%) in the obese patient group and  10(14.7%) in morbid obese patient group (p=0.043). Duration of hospital stay was 12 days in obese patient group and 10 days in morbid obese patient group. 30-day mortality was equal in both groups with 4.4%.

 Conclusion.  According to our study there was not any risk factor which can increase mortality and morbidity in morbid obese patients when they compared with obese patients

Kaynakça

  • 1. Moulton MJ, Creswell LL, Mackey ME, Cox JL, Rosenbloom M. Obesity is not a risk factor for significant adverse outcomes after cardiac surgery. Circulation 1996;95(Suppl 9):1187–92
  • 2. Christakis GT, Weisel RD, Buth KJ, Fremes SE, Rao V, Panagioto- poulos KP, Ivanov J, Goldman BS, David TE. Is body size the cause of poor outcomes of coronary artery bypass operations in women? J Thorac Cardiovasc Surg 1995;110:1344–58
  • 3. Oreopoulos A, Padwal R, Norris CM, Mullen JC, Pretorius V, Kalantar-Zadeh K. Effect of obesity on short- and long-term mortality postcoronary revascularization: a meta-analysis. Obesity (Silver Spring) 2008;16:442–50
  • 4. Engelman DT, Adams DH, Byrne JG, et al. Impact of body mass index and albumin on morbidity and mortality after cardiac surgery. J Thorac Cardiovasc Surg 1999;118:866–73
  • 5. Reeves BC, Ascione R, Chamberlain MH, Angelini GD. Effect of body mass index on early outcomes in patients undergoing coronary artery bypass surgery. J Am Coll Cardiol 2003;42:668–76
  • 6. Manoj K, Antony DG, Aung YO, Brian MF and Abbas R. Risk of morbidity and in-hospital mortality in obese patients undergoing coronary artery bypass surgery. Eur J Cardiothorac Surg 2002; 22(5):787-793
  • 7. Christopher H, Wigfield R, Joshua D, LindseyAM, Parmjeet S, Chopra NM, Edwards S, Robert B. Love Is extremeobesity a risk factor for cardiac surgery? An analysis of patients with a BMI>40kg/m2 . Eur J Cardiothorac Surg 2006; 434-440
  • 8. Koshal A, Hendry P, Raman SV, Keon WJ. Should obese patients not undergo coronary artery surgery? Can J Surg 1985;28:331-4
  • 9. Gökcen O, Yesim B, Serap AA, Murat S, Serap S, Sahin S, Zuhal A, Ergin E. Coronary artery bypass graft operation can be performed safely in obese patients. European Journal of Cardio thorasic surgery 25(2004) 212-217
  • 10. Brandt M, Harder K, Walluscheck KP, Schottler J, Rahimi A, Moller F, Cremer J. Severe obesity does not adversely affect perioperative mortality and morbidity in coronary artery bypass surgery. Eur J Cardiothorac Surg 2001;19:662-666
  • 11. Grayson AD, Oo AY, Fabri BM, Rashid A. Risk of morbidity and in hospital mortality in obese patients undergoing coronary artery bypass surgery. Eur J Cardiothorac Surg 2002;22:787-793

Koroner Arter Baypas Greft Operasyonu Yapılan Obez ve Morbid Obez Hastaların Karşılaştırılması

Yıl 2018, , 890 - 899, 15.08.2018
https://doi.org/10.30569/adiyamansaglik.435696

Öz

Amaç: Obezite ve morbid obezite gelişmekte olan  ülkelerde önemli bir halk sağlığı sorunu
olarak toplumu tehdit etmektedir. Bununla birlikte bir çok  obez veya morbid obez   hastada 
koroner arter hastalığı nedeniyle koroner arter baypas greftleme operasyonuna
ihtiyaç duyulmaktadır. Biz de bu çalışmada kliniğimizde koroner arter baypas
greftleme yaptığımız obez ve morbid obez hastaları retrospektif olarak
inceleyerek bu hastalarda mortalite ve

morbiditeyi artıran risk faktörlerini  
karşılaştırmayı
amaçladık.



Yöntem . 2008 ile 2014
yılları arasında kliniğimizde koroner arter hastalığı nedeni ile takip edilen
obez ve morbid obez hastalardan koroner arter baypas greftleme uygulanan
hastaları retrospesfik olarak inceledik. Belirtilen yıllar arasında  593 hastaya koroner arter baypas greftleme  uygulanmıştı. Bu hastalar obez (n=69) ve
morbid obez (n=68) olmalarına göre iki gruba ayrıldı. Morbid obez hastaların
vücut kitle indeksleri 35 kg/m
2 
ve vücut yüzey alanları 2.0 kg/m
2  ‘nin üzerinde idi. Obez hastaların ise vücut
kitle indeksleri 25-35 kg/m
2 ve vücut yüzey alanları 1.8-2.0 kg/m2
 arasındaydı.



Bulgular: Hastaların median yaşları obez hasta grubunda 61,20±9,04, morbid obez hasta grubunda 60,54±10,65
idi. Obez hasta grubunda diabetes mellitus 32 (%46,4), morbid obez hasta
grubunda ise 20 (% 29,4) hastada mevcuttu (p=0.041). Anstabil anjina pektoris
şikayeti olan hasta sayısı obez hasta grubunda 20(% 29) morbid obez hasta
grubunda ise 10(%14,7)'du (p=0.043). Hastanede kalış süresi obez hasta grubunda
10 gün morbid obez hasta grubunda ise 12 gün idi. 30 günlük mortalite her iki
grupta eşit olmakla birlikte % 4,4 idi.



 Sonuç: Morbid obez ile
obez hastalar karşılatırıldığında morbid obez olanlarda koroner arter baypas
greftleme için artmış mortalite ve morbiditeye sebep olacak risk faktörleri
olmadığı düşünülmektedir.






 




Kaynakça

  • 1. Moulton MJ, Creswell LL, Mackey ME, Cox JL, Rosenbloom M. Obesity is not a risk factor for significant adverse outcomes after cardiac surgery. Circulation 1996;95(Suppl 9):1187–92
  • 2. Christakis GT, Weisel RD, Buth KJ, Fremes SE, Rao V, Panagioto- poulos KP, Ivanov J, Goldman BS, David TE. Is body size the cause of poor outcomes of coronary artery bypass operations in women? J Thorac Cardiovasc Surg 1995;110:1344–58
  • 3. Oreopoulos A, Padwal R, Norris CM, Mullen JC, Pretorius V, Kalantar-Zadeh K. Effect of obesity on short- and long-term mortality postcoronary revascularization: a meta-analysis. Obesity (Silver Spring) 2008;16:442–50
  • 4. Engelman DT, Adams DH, Byrne JG, et al. Impact of body mass index and albumin on morbidity and mortality after cardiac surgery. J Thorac Cardiovasc Surg 1999;118:866–73
  • 5. Reeves BC, Ascione R, Chamberlain MH, Angelini GD. Effect of body mass index on early outcomes in patients undergoing coronary artery bypass surgery. J Am Coll Cardiol 2003;42:668–76
  • 6. Manoj K, Antony DG, Aung YO, Brian MF and Abbas R. Risk of morbidity and in-hospital mortality in obese patients undergoing coronary artery bypass surgery. Eur J Cardiothorac Surg 2002; 22(5):787-793
  • 7. Christopher H, Wigfield R, Joshua D, LindseyAM, Parmjeet S, Chopra NM, Edwards S, Robert B. Love Is extremeobesity a risk factor for cardiac surgery? An analysis of patients with a BMI>40kg/m2 . Eur J Cardiothorac Surg 2006; 434-440
  • 8. Koshal A, Hendry P, Raman SV, Keon WJ. Should obese patients not undergo coronary artery surgery? Can J Surg 1985;28:331-4
  • 9. Gökcen O, Yesim B, Serap AA, Murat S, Serap S, Sahin S, Zuhal A, Ergin E. Coronary artery bypass graft operation can be performed safely in obese patients. European Journal of Cardio thorasic surgery 25(2004) 212-217
  • 10. Brandt M, Harder K, Walluscheck KP, Schottler J, Rahimi A, Moller F, Cremer J. Severe obesity does not adversely affect perioperative mortality and morbidity in coronary artery bypass surgery. Eur J Cardiothorac Surg 2001;19:662-666
  • 11. Grayson AD, Oo AY, Fabri BM, Rashid A. Risk of morbidity and in hospital mortality in obese patients undergoing coronary artery bypass surgery. Eur J Cardiothorac Surg 2002;22:787-793
Toplam 11 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi
Yazarlar

Ata Niyazi Ecevit

Özgür Altınbaş

Cengiz Güven

Yayımlanma Tarihi 15 Ağustos 2018
Gönderilme Tarihi 22 Haziran 2018
Kabul Tarihi 13 Temmuz 2018
Yayımlandığı Sayı Yıl 2018

Kaynak Göster

AMA Ecevit AN, Altınbaş Ö, Güven C. Koroner Arter Baypas Greft Operasyonu Yapılan Obez ve Morbid Obez Hastaların Karşılaştırılması. ADYÜ Sağlık Bilimleri Derg. Ağustos 2018;4(2):890-899. doi:10.30569/adiyamansaglik.435696