Original articleCardiovascularRelationship of Body Mass Index With Outcomes After Coronary Artery Bypass Graft Surgery
Section snippets
Material and Methods
The Department of Veterans Affairs (VA) Continuous Improvement in Cardiac Surgery Program (CICSP) prospectively collects patient-level risk, procedural, and outcome data on all patients undergoing cardiac surgery at the 45 VA cardiac surgical centers. The goal of the CICSP is to provide performance reports to VA-based clinical care team members for use in self-assessment and self-improvement quality of care initiatives. A description of this complete database and the variables captured has been
Results
The distributions across BMI classes of these risk factors for the patients included in this analysis are displayed in Table 1. Of the 80,792 patients, 887 (1.1%) were classified as underweight (BMI < 18.5), 18,130 (22.4%) were normal weight (18.5 ≤ BMI < 25), 34,063 (42.2%) were overweight (25 ≤ BMI < 30), 19,391 (24.0%) were obese (30 ≤ BMI < 35), and 8,321 (10.3%) were morbidly obese (BMI ≥ 35). Increasing BMI was associated with younger age, lower rates of smoking and chronic obstructive
Comment
The primary goal of this study was to estimate the risks of death and major complications as nonlinear functions of BMI during the period directly after CABG surgery. We found that the relation between BMI and post-CABG outcomes was significantly nonlinear, and when BMI was tested as a linear function or using a category for obesity, it did not result in a significant predictor in the model. Risks were higher in the extremes of BMI, with minimum risk occurring near a BMI of 30 kg/m2. Adjustment
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