Heuts, Samuel and Mariani, Silvia and van Bussel, Bas C. T. and Boeken, Udo and Samalavicius, Robertas and Bounader, Karl and Hou, Xiaotong and Bunge, Jeroen J. H. and Sriranjan, Kogulan and Wiedemann, Dominik and Saeed, Diyar and Pozzi, Matteo and Loforte, Antonio and Salazar, Leonardo and Meyns, Bart and Mazzeffi, Michael A. and Matteucci, Sacha and Sponga, Sandro and Sorokin, Vitaly and Russo, Claudio and Formica, Francesco and Sakiyalak, Pranya and Fiore, Antonio and Camboni, Daniele and Raffa, Giuseppe Maria and Diaz, Rodrigo and Wang, I-wen and Jung, Jae-Seung and Belohlavek, Jan and Pellegrino, Vin and Bianchi, Giacomo and Pettinari, Matteo and Barbone, Alessandro and Garcia, Jose P. and Shekar, Kiran and Whitman, Glenn and Lorusso, Roberto (2023) The Relation Between Obesity and Mortality in Postcardiotomy Venoarterial Membrane Oxygenation. ANNALS OF THORACIC SURGERY, 116 (1). pp. 147-154. ISSN 0003-4975, 1552-6259
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BACKGROUND Obesity is an important health problem in cardiac surgery and among patients requiring postcardiotomy venoarterial extracorporeal membrane oxygenation (V-A ECMO). Still, whether these patients are at risk for unfavorable outcomes after postcardiotomy V-A ECMO remains unclear. The current study evaluated the association between body mass index (BMI) and in-hospital outcomes in this setting. METHODS The Post-cardiotomy Extracorporeal Life Support (PELS-1) study is an international, multicenter study. Patients requiring postcardiotomy V-A ECMO in 36 centers from 16 countries between 2000 and 2020 were included. Patients were divided in 6 BMI categories (underweight, normal weight, overweight, class I, class II, and class III obesity) according to international recommendations. Primary outcome was in-hospital mortality, and secondary outcomes included major adverse events. Mixed logistic regression models were applied to evaluate associations between BMI and mortality. RESULTS The study cohort included 2046 patients (median age, 65 years; 838 women [41.0%]). In-hospital mortality was 60.3%, without statistically significant differences among BMI classes for in-hospital mortality (P = .225) or major adverse events (P = .126). The crude association between BMI and in-hospital mortality was not statistically significant after adjustment for comorbidities and intraoperative variables (class I: odds ratio [OR], 1.21; 95% CI, 0.88-1.65; class II: OR, 1.45; 95% CI, 0.86-2.45; class III: OR, 1.43; 95% CI, 0.62-3.33), which was confirmed in multiple sensitivity analyses. CONCLUSIONS BMI is not associated to in-hospital outcomes after adjustment for confounders in patients undergoing postcardiotomy V-A ECMO. Therefore, BMI itself should not be incorporated in the risk stratification for postcardiotomy V-A ECMO. 2023 by The Society of Thoracic Surgeons. Published by Elsevier Inc.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CARDIAC-SURGERY; RISK; OUTCOMES; PARADOX; ADULTS; ECMO; |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 02 Feb 2024 06:26 |
| Last Modified: | 02 Feb 2024 06:26 |
| URI: | https://pred.uni-regensburg.de/id/eprint/60943 |
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