Obese Cardiac Patients Need More Post-Surgical Care

Obesity is associated with a significant increase in intensive care unit (ICU) resource utilization following cardiac operations, according to a new study.

Researchers at Saint John Regional Hospital (Saint John, Canada) and Dalhousie Medicine New Brunswick (DMNB; Saint John, Canada) conducted a study that included 5,365 patients with a body mass index (BMI) of 18.5 kg/m2 or higher who underwent a cardiac surgical procedure at the New Brunswick Heart Centre (Saint John, Canada) between 2006 and 2013. The patients were by stratified by BMI; normal (18.5-25), pre-obese (25-30), obese class I (30-35), obese class II (35-40), and obese class III (BMI over 40).

Comparisons between weight categories were performed, with risk-adjusted effect of weight category on prolonged ICU stay, prolonged ventilation, and ICU readmission determined. The results showed that following surgery, the 1,948 patients classified as obese were four times more likely to require extra time in the ICU, three times more likely to need additional time on mechanical ventilation, and three times more likely to be readmitted to the ICU. The study was published on August 9, 2017, in Annals of Thoracic Surgery.

“Obesity is a growing problem for society that has reached epidemic proportions. We saw that as patients became more obese, the hospital resources required to care for them after heart surgery also increased,” said lead author Brandon Rosvall, BSc, of DMNB. “Expensive resources, including staff, medical equipment, and medication are needed to provide these services. By more efficiently using ICU resources, we can save the health care system money, while also improving overall patient care.”

BMI is a value is defined as the body mass divided by the square of the body height, and is universally expressed in units of kg/m2. It is generally used as a means of correlation between groups related by general mass, and can serve as a means of estimating adiposity. Commonly accepted BMI ranges are underweight (under 18.5), normal (18.5-25), overweight (25-30), and obese (over 30). BMI has been used by the World health Organization (WHO) as the standard for recording obesity statistics since the early 1980s.

Related Links:
Saint John Regional Hospital
Dalhousie Medicine New Brunswick