Impact of body mass index on early and mid-term outcomes after surgery for acute Stanford type A aortic dissection

Abstract Background Obesity is dramatically increasing worldwide, and more obese patients may develop aortic dissection and present for surgical repair. The study aims to analyse the impact of body mass index (BMI) on surgical outcomes in patients with acute Stanford type A aortic dissection (ATAAD)...

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Main Authors: Yanxiang Liu, Bowen Zhang, Shenghua Liang, Yaojun Dun, Luchen Wang, Haoyu Gao, Jie Ren, Hongwei Guo, Xiaogang Sun
Format: Article
Language:English
Published: BMC 2021-06-01
Series:Journal of Cardiothoracic Surgery
Subjects:
Online Access:https://doi.org/10.1186/s13019-021-01558-z
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author Yanxiang Liu
Bowen Zhang
Shenghua Liang
Yaojun Dun
Luchen Wang
Haoyu Gao
Jie Ren
Hongwei Guo
Xiaogang Sun
author_facet Yanxiang Liu
Bowen Zhang
Shenghua Liang
Yaojun Dun
Luchen Wang
Haoyu Gao
Jie Ren
Hongwei Guo
Xiaogang Sun
author_sort Yanxiang Liu
collection DOAJ
description Abstract Background Obesity is dramatically increasing worldwide, and more obese patients may develop aortic dissection and present for surgical repair. The study aims to analyse the impact of body mass index (BMI) on surgical outcomes in patients with acute Stanford type A aortic dissection (ATAAD). Methods From January 2017 to June 2019, the clinical data of 268 ATAAD patients in a single centre were retrospectively reviewed. They were divided into three groups based on the BMI: normal weight (BMI 18.5 to < 25 kg/m2, n = 110), overweight (BMI 25 to < 30 kg/m2, n = 114) and obese (BMI ≥30 kg/m2, n = 44). Results There was no statistical difference among the three groups in terms of the composite adverse events including 30-day mortality, stroke, paraplegia, renal failure, hepatic failure, reintubation or tracheotomy and low cardiac output syndrome (20.9% vs 21.9% vs 18.2% for normal, overweight and obese, respectively; P = 0.882). No significant difference was found in the mid-term survival among the three groups. The proportion of prolonged ventilation was highest in the obese group followed by the overweight and normal groups (59.1% vs 45.6% vs 34.5%, respectively; P = 0.017). Multivariable logistic regression analysis suggested that BMI was not associated with the composite adverse events, while BMI ≥30 kg/m2 was an independent risk factor for prolonged ventilation (OR 2.261; 95% CI 1.056–4.838; P = 0.036). Conclusions BMI had no effect on the early major adverse outcomes and mid-term survival after surgery for ATAAD. Satisfactory surgical outcomes can be obtained in patients with ATAAD at all weights.
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spelling doaj.art-5b3b4388629f47fabc020d7bd7f937d82022-12-21T22:04:51ZengBMCJournal of Cardiothoracic Surgery1749-80902021-06-011611810.1186/s13019-021-01558-zImpact of body mass index on early and mid-term outcomes after surgery for acute Stanford type A aortic dissectionYanxiang Liu0Bowen Zhang1Shenghua Liang2Yaojun Dun3Luchen Wang4Haoyu Gao5Jie Ren6Hongwei Guo7Xiaogang Sun8Department of Vascular Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Vascular Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Vascular Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Vascular Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Vascular Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Vascular Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Vascular Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Vascular Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of Vascular Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical CollegeAbstract Background Obesity is dramatically increasing worldwide, and more obese patients may develop aortic dissection and present for surgical repair. The study aims to analyse the impact of body mass index (BMI) on surgical outcomes in patients with acute Stanford type A aortic dissection (ATAAD). Methods From January 2017 to June 2019, the clinical data of 268 ATAAD patients in a single centre were retrospectively reviewed. They were divided into three groups based on the BMI: normal weight (BMI 18.5 to < 25 kg/m2, n = 110), overweight (BMI 25 to < 30 kg/m2, n = 114) and obese (BMI ≥30 kg/m2, n = 44). Results There was no statistical difference among the three groups in terms of the composite adverse events including 30-day mortality, stroke, paraplegia, renal failure, hepatic failure, reintubation or tracheotomy and low cardiac output syndrome (20.9% vs 21.9% vs 18.2% for normal, overweight and obese, respectively; P = 0.882). No significant difference was found in the mid-term survival among the three groups. The proportion of prolonged ventilation was highest in the obese group followed by the overweight and normal groups (59.1% vs 45.6% vs 34.5%, respectively; P = 0.017). Multivariable logistic regression analysis suggested that BMI was not associated with the composite adverse events, while BMI ≥30 kg/m2 was an independent risk factor for prolonged ventilation (OR 2.261; 95% CI 1.056–4.838; P = 0.036). Conclusions BMI had no effect on the early major adverse outcomes and mid-term survival after surgery for ATAAD. Satisfactory surgical outcomes can be obtained in patients with ATAAD at all weights.https://doi.org/10.1186/s13019-021-01558-zBody mass indexAcute Stanford type a aortic dissectionFrozen elephant trunk
spellingShingle Yanxiang Liu
Bowen Zhang
Shenghua Liang
Yaojun Dun
Luchen Wang
Haoyu Gao
Jie Ren
Hongwei Guo
Xiaogang Sun
Impact of body mass index on early and mid-term outcomes after surgery for acute Stanford type A aortic dissection
Journal of Cardiothoracic Surgery
Body mass index
Acute Stanford type a aortic dissection
Frozen elephant trunk
title Impact of body mass index on early and mid-term outcomes after surgery for acute Stanford type A aortic dissection
title_full Impact of body mass index on early and mid-term outcomes after surgery for acute Stanford type A aortic dissection
title_fullStr Impact of body mass index on early and mid-term outcomes after surgery for acute Stanford type A aortic dissection
title_full_unstemmed Impact of body mass index on early and mid-term outcomes after surgery for acute Stanford type A aortic dissection
title_short Impact of body mass index on early and mid-term outcomes after surgery for acute Stanford type A aortic dissection
title_sort impact of body mass index on early and mid term outcomes after surgery for acute stanford type a aortic dissection
topic Body mass index
Acute Stanford type a aortic dissection
Frozen elephant trunk
url https://doi.org/10.1186/s13019-021-01558-z
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