Relationship Between Body Fat and Morbidity and Mortality in Cardiac Surgery

Diego Costa, Maximiliano Muzzio, Leonardo García Iturralde, Guillermina Esperón, Luciana Córsico, Enzo Catena, Carlos Luis Gonzalez, Vanesa Gregorietti, Luciano Saglietti, Roberto Coronel


Introduction: There is a potentially protective effect of obesity when it coexists with cardiovascular disease, known as the“obesity paradox.” It could be explained by the fact that anthropometric measurements are not a reliable marker of bodyfat. In this study we propose to estimate body fat with a non-invasive method and study its relationship with morbidity andmortality in cardiac surgery.Methods: We conducted a prospective and observational study in adult patients undergoing cardiac surgery. We analyzed demographic,anthropometric and clinical variables along with the estimation of body composition using bioelectric impedance,to study their association to hospitalization days and adverse events after cardiac surgery.Results: In the analysis of 98 patients, we found a direct relationship between the percentage of body fat and the length ofhospital stay, independent of age, sex, body mass index (BMI) and surgical risk (coefficient of 0.27, p = 0.021). In addition,patients who had mediastinitis showed a significantly higher body fat (31.55 ± 0.64% versus 27.13 ± 7.9%, p <0.001), andpatients who died had a tendency to have more fat mass (36.05 ± 3.19% versus 27.20 ± 7.82%, p = 0.08).Conclusion: Increased body fat as assessed with BIA was related to morbidity in cardiac surgery. Although this is biologicallyplausible, it would be necessary to carry out larger studies in order to definitively establish the “BMI paradox”.


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