Preoperative Leukocyte Counts Increase Risk of Adverse Outcomes in Obese Patient Undergoing Cardiac Surgery.
In this study, we sought to determine whether the white blood
cell (WBC) response may be an additional predictor for postoperative morbidities in obese patients
undergoing cardiac surgery. A total of 1,171 consecutive patients who underwent cardiac surgery
were retrospectively reviewed. Patients were divided into three groups based on their body mass
index (BMI): non-obese (BMI < 30 kg/m²), obese (BMI 30-34.9 kg/m²) and severely obese (BMI ≥
35 kg/m²). We used serial WBC count as an index of inflammation. Postoperative infection rate
and postoperative hospital and intensive care unit (ICU) lengths of stay (LOS) were the primary
endpoints. Obese and severely obese patients had significantly higher preoperative WBC counts
and greater changes from the baseline at 24 h post-operation (P < 0.01). Obese and severely obese
patients had significantly higher postoperative infection rate (P < 0.01). The postoperative LOS
was significantly longer in severely obese patients (P = 0.03), and the ICU LOS was significantly
longer in severely obese patients compared to non-obese patients (P = 0.02). Using logistic regression
analysis, we identified the preoperative WBC count as an independent predictor for longer ICU
stay and higher postoperative infection rate, and changes in WBC from preoperative baseline as a
predictor for postoperative length of hospital stay in addition to BMI. Obese patients have increased
postoperative morbidity after cardiac surgery. In addition to BMI, ...
Source: The Chinese Journal of Physiology - Category: Physiology Tags: Chin J Physiol Source Type: research
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