scholarly journals Association of Body Mass Index With Postoperative Early Adverse Outcomes in Acute Type a Aortic Dissection Patients in Fujian Province, China: A Retrospective Study

2020 ◽  
Author(s):  
Lingyu Lin ◽  
Yanjuan Lin ◽  
Qiong Chen ◽  
Yanchun Peng ◽  
Sailan Li ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Aortic Dissection ◽  
Body Mass ◽  
Logistic Regression Analysis ◽  
Adverse Outcomes ◽  
Acute Type ◽  
Obese Patients ◽  
Type A Aortic Dissection

Abstract Background: Abnormal body mass index (BMI) has been related to a higher risk of adverse perioperative outcomes in patients undergoing cardiac surgery. However, the effects of BMI in patients with acute type A aortic dissection (AAAD) on postoperative outcomes remain unclear. The aims of this study were to explore the relationships of BMI and postoperative early adverse outcomes in AAAD patientsMethods: Patients who underwent AAAD surgery at Fujian Province Cardiac Medical Research Center from June 2013 to March 2020 were retrospectively evaluated. They were divided into three groups on the basis of Chinese BMI classification established by the World Health Organization: normal group (BMI 18.5-23.9 kg/m2), overweight group (BMI 24-27.9 kg/m2), and obesity group (BMI > 28kg/m2). Preoperative, intraoperative, and postoperative data were collected. Multivariable and univariable logistic regression analysis models were performed to identify whether BMI was independently associated with postoperative adverse outcomes.Results: Of 777 cases, 31.9% were normal weight, 52.5% were overweight, and 15.6% were obese. The percentage of prolonged mechanical ventilation (44.9% vs 55.8% vs 66.1%, respectively; P<0.001) and the median duration of intensive care unit stays (8.1 vs 9.5 vs 12.0 days, respectively; P<0.001) were higher and longer in the overweight and obese group. Multivariable logistic regression analysis demonstrated that a higher risk of postoperative early adverse outcomes in the overweight (odds ratio [OR]: 2.374, 95%CI: 1.647–3.422), and obese patients (OR: 3.659, 95%CI: 2.122–6.308) with reference to the normal BMI patients, and age, heart rate, and surgery duration were also associated with postoperative early adverse outcomes (P<0.05).Conclusion: Overweight and obese patients are independently associated with higher postoperative early adverse outcomes in patients who underwent AAAD surgery.

scholarly journals Association of body mass index with in-hospital major adverse outcomes in acute type A aortic dissection patients in Fujian Province, China: a retrospective study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lingyu Lin ◽  
Yanjuan Lin ◽  
Qiong Chen ◽  
Yanchun Peng ◽  
Sailan Li ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Aortic Dissection ◽  
Logistic Regression Analysis ◽  
Normal Weight ◽  
Adverse Outcomes ◽  
Multivariable Logistic Regression Analysis ◽  
Acute Type ◽  
Type A Aortic Dissection

Abstract Background Abnormal body mass index (BMI) has been related to a higher risk of adverse outcomes in patients undergoing cardiac surgery. However, the effects of BMI in patients with acute type A aortic dissection (AAAD) on postoperative outcomes remain unclear. This study aimed to explore the relationships between BMI and in-hospital major adverse outcomes (MAO) in AAAD patients. Methods Patients who underwent AAAD surgery at Cardiac Medical Center of Fujian Province from June 2013 to March 2020 were retrospectively evaluated. They were divided into three groups on the basis of Chinese BMI classification established by the World Health Organization: normal weight group (BMI 18.5–23.9 kg/m2), overweight group (BMI 24–27.9 kg/m2), and obese group (BMI >28 kg/m2). Patients’ baseline characteristics, preoperative, operative, and postoperative data were collected. A multivariable logistic regression analysis model was performed to identify the association between BMI and MAO in AAAD patients. Results Of 777 cases, 31.9% were normal weight, 52.5% were overweight, and 15.6% were obese. A total of 160(20.6%) patients died in-hospital. There was a significant difference between the three groups for MAO (62.9% vs 72.1% vs 77.7%, respectively, P = 0.006). The incidence of postoperative complications did not differ among the three groups, except for postoperative bleeding, and prolonged mechanical ventilation, the proportion of which were higher in the overweight and obese groups. Besides, multivariable logistic regression analysis demonstrated that a higher risk of MAO in the overweight [odds ratios (ORs):1.475, 95%CI:1.006–2.162], and obese patients (ORs:2.147, 95%CI:1.219–3.782) with reference to the normal weight patients, and age, white blood cell, prior stroke and cardiopulmonary bypass time were also associated with in-hospital MAO (P<0.05). Conclusions BMI is independently associated with higher in-hospital MAO in patients who underwent AAAD surgery.

scholarly journals Association of body mass index with in-hospital major adverse outcomes in acute type A aortic dissection patients in Fujian Province, China: a retrospective study

2021 ◽  
Author(s):  
Lingyu Lin ◽  
Yanjuan Lin ◽  
Qiong Chen ◽  
Yanchun Peng ◽  
Sailan Li ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Aortic Dissection ◽  
Logistic Regression Analysis ◽  
Normal Weight ◽  
Adverse Outcomes ◽  
Multivariable Logistic Regression Analysis ◽  
Acute Type ◽  
Type A Aortic Dissection

Abstract Background: Abnormal body mass index(BMI) has been related to a higher risk of adverse outcomes in patients undergoing cardiac surgery. However, the effects of BMI in patients with acute type A aortic dissection(AAAD) on postoperative outcomes remain unclear. This study aimed to explore the relationships between BMI and in-hospital major adverse outcomes(MAO) in AAAD patients.Methods: Patients who underwent AAAD surgery at Fujian Province Cardiac Medical Research Center from June 2013 to March 2020 were retrospectively evaluated. They were divided into three groups on the basis of Chinese BMI classification established by the World Health Organization: normal weight group(BMI 18.5-23.9 kg/m2), overweight group(BMI 24-27.9 kg/m2), and obese group(BMI ＞28kg/m2). Patients’ baseline characteristics, preoperative, operative, and postoperative data were collected. A multivariable logistic regression analysis model was performed to identify the association between BMI and MAO in AAAD patients.Results: Of 777 cases, 31.9% were normal weight, 52.5% were overweight, and 15.6% were obese. A total of 160(20.6%) patients died in-hospital. There was a significant difference between the three groups for MAO(62.9% vs 72.1% vs 77.7%, respectively; P=0.006). The incidence of postoperative complications did not differ among the three groups, except for postoperative bleeding, and prolonged mechanical ventilation, the proportion of which were higher in the overweight and obese groups. Besides, multivariable logistic regression analysis demonstrated that a higher risk of MAO in the overweight [odds ratios(ORs):1.475, 95%CI:1.006-2.162], and obese patients(ORs:2.147, 95%CI:1.219-3.782) with reference to the normal weight patients, and age, white blood cell, prior stroke and cardiopulmonary bypass time were also associated with in-hospital MAO (P＜0.05).Conclusions: BMI is independently associated with higher in-hospital MAO in patients who underwent AAAD surgery.

scholarly journals The association between body mass index and severity of Coronavirus Disease 2019 (COVID-19): A cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247023
Author(s):  
Kulapong Jayanama ◽  
Sirawat Srichatrapimuk ◽  
Kanin Thammavaranucupt ◽  
Suppachok Kirdlarp ◽  
Supawadee Suppadungsuk ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Cohort Study ◽  
Body Mass ◽  
Logistic Regression Analysis ◽  
Severe Pneumonia ◽  
Adverse Outcomes ◽  
Icu Stay ◽  
Underweight Patients

Objectives The coronavirus disease 2019 (COVID-19) has become a worst pandemic. The clinical characteristics vary from asymptomatic to fatal. This study aims to examine the association between body mass index (BMI) levels and the severity of COVID-19. Methods and study design A cohort study included 147 adult patients with confirmed COVID-19 were categorized into 4 groups by BMI levels on admission: <18.5 (underweight), 18.5–22.9 (normal weight), 23.0–24.9 (overweight), and ≥25.0 kg/m2 (obese). Rates of pneumonia, severe pneumonia, acute kidney injury (AKI), and ICU stay during hospitalization across BMI group was determined. Logistic regression analysis was used to determine the association between BMI and severe pneumonia. Results Of the totals, patients having a BMI <18.5, 18.5–22.9, 23.0–24.9, and ≥25.0 kg/m2 were 12.9%, 38.1%, 17.7%, and 31.3%, respectively. The rates of pneumonia and severe pneumonia tended to be higher in patients with higher BMI, whereas the rates of AKI and ICU stay were higher in patients with BMI <18.5 kg/m2 and ≥ 25 kg/m2, when compared to patients with normal BMI. After controlling for age, sex, diabetes, hypertension and dyslipidemia in the logistic regression analysis, having a BMI ≥25.0 kg/m2 was associated with higher risk of severe pneumonia (OR 4.73; 95% CI, 1.50–14.94; p = 0.003) compared to having a BMI 18.5–22.9 kg/m2. During admission, elevated hemoglobin and alanine aminotransferase levels on day 7 and 14 of illness were associated with higher BMI levels. In contrast, rising of serum creatinine levels was observed in underweight patients on days 12 and 14 of illness. Conclusions Obesity in patients with COVID-19 was associated with severe pneumonia and adverse outcomes such as AKI, transaminitis and ICU stay. Underweight patients should be closely monitored for AKI. Further studies in body composition are warranted to explore the links between adiposity and COVID-19 pathogenesis.

scholarly journals Association between obesity and venous thromboembolism

2020 ◽  
Author(s):  
Cristina Hotoleanu
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Risk Factor ◽  
Venous Thromboembolism ◽  
Body Mass ◽  
Logistic Regression Analysis ◽  
The Body ◽  
Increased Risk

Background and aims. Obesity is associated with numerous pathological conditions, including venous thromboembolism (VTE). VTE is a multifactorial disease; more than half of the hospitalized patients are at risk for VTE. We aimed to assess the risk of VTE associated with obesity, taking into account the class of obesity (according to the body mass index), gender, age and the intervention of other acquired risk factors. Method. A case-control study including 732 patients was designed. Collected data included: age, gender, body mass index, pregnancy/ postpartum state, use of hormonal therapy, personal and family history of VTE, smoking, prolonged immobilization and the presence of comorbidities- acquired risk factors for VTE. The risk of VTE was expressed as odds ratio (OR) with 95% confidence interval. Multiple logistic regression analysis was used to detect the independent risk factors. P value < 0.05 was considered significant statistic. Results. Obesity was associated with a 6.2- fold increased risk for VTE. The risk of VTE associated with obesity was highest in patients aged >50 years and in cases included in classes II and III of obesity. The interaction between obesity and another acquired risk factor has almost doubled the risk of VTE. Multivariate logistic regression analysis showed obesity as an independent risk factor for VTE for both female and male patients. Conclusion. Obesity is an independent and moderate risk factor for VTE. The risk increases with body mass index, age and the presence of other acquired risk factors.

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

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yanxiang Liu ◽  
Bowen Zhang ◽  
Shenghua Liang ◽  
Yaojun Dun ◽  
Luchen Wang ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Adverse Events ◽  
Aortic Dissection ◽  
Body Mass ◽  
Surgical Outcomes ◽  
Type A ◽  
Term Survival ◽  
Type A Aortic Dissection ◽  
Prolonged Ventilation ◽  
The Impact

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.

scholarly journals Impacts of eosinophil percentage on prognosis acute type A aortic dissection patients

2021 ◽  
Author(s):  
Yue Shao ◽  
Liu Ye ◽  
Hao-ming Shi ◽  
Xin-mei Wang ◽  
Jun Luo ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Aortic Dissection ◽  
Multivariate Regression ◽  
Medical Information ◽  
External Validation ◽  
Inflammatory Cells ◽  
Type A ◽  
Multivariate Regression Analysis ◽  
Acute Type ◽  
Type A Aortic Dissection

Abstract Background Eosinophils are pro-inflammatory cells involved in thrombosis and have been proposed as a prognosis marker in acute ischemic stroke and ST-elevation myocardial Infarction. Here, we sought to clarify the prognostic value of eosinophil percentage (EOS%) in patients with acute type A aortic dissection (AAAD). Methods We examined 183 consecutive AAAD patients. Based on the optimum cut-off value of EOS% determined by X-tile software, patients were classified into the low EOS% (EOS%≤0.1) and high EOS% groups (EOS%>0.1). We performed multivariate regression analysis and Kaplan-Meier (KM) survival curves to assess the association between EOS% and mortality. Eosinophil accumulation in aortic dissection intraluminal thrombus was confirmed using hematoxylin–eosin (H&E) staining. An external cohort from Medical Information Mart for Intensive Care IV was performed to validate the results. Results Relative to surviving patients, those who died during hospitalization had significantly lower EOS% (p=0.001) but significantly higher WBC (p=0.002) and neutrophil (p=0.001) counts. Multivariate regression analysis identified EOS% as an independent predictor of in-hospital and 1-year mortality. KM curves revealed that 1-year cumulative mortality was significantly higher in the low EOS% group, although it was mainly attributed to the higher 30-day mortality. H&E staining revealed massive infiltration of eosinophils in all 20 thrombus specimens. The external validation confirmed that relative to survivors, patients with in-hospital (p=0.010) had significantly lower EOS%. Moreover, multivariate regression analyses identified that decreased EOS% was independently significantly associated with in-hospital mortality. Conclusions Low EOS% is significantly related to increased mortality rates in AAAD patients.

Serum myonectin is increased after laparoscopic sleeve gastrectomy

2020 ◽  
Vol 57 (5) ◽  
pp. 360-364
Author(s):  
Lei Li ◽  
Qianqian Wang ◽  
Chengkun Qin
Keyword(s):  
Body Mass Index ◽  
Regression Analysis ◽  
Sleeve Gastrectomy ◽  
Linear Regression ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Body Mass ◽  
Linear Regression Analysis ◽  
Acid Uptake ◽  
Model Assessment ◽  
Obese Patients

Objective Myonectin, a newly discovered myokine, enhances fatty acid uptake in cultured adipocytes and hepatocytes and suppresses circulating levels of free fatty acids in mice. Recent studies showed that serum myonectin concentration is negatively correlated with obesity. This study was undertaken to evaluate the change of serum myonectin in obese patients after laparoscopic sleeve gastrectomy. Methods This study was performed in a population of 42 obese and 58 control subjects from April of 2018 to December of 2019. All obese subjects underwent laparoscopic sleeve gastrectomy. Anthropometric measurements, lipid profiles, HbA1c and serum myonectin were assessed at baseline and six months after laparoscopic sleeve gastrectomy. Results Serum myonectin concentrations were significantly lower in the obese patients than in the controls. Serum myonectin concentrations were increased at six months after laparoscopic sleeve gastrectomy. Simple linear regression analysis indicated that serum myonectin was negatively correlated with weight, waist circumference, hip circumference, body mass index, fasting plasma glucose, homeostasis model assessment of insulin resistance and HbA1c. Only body mass index was still inversely correlated with serum myonectin after multiple linear regression analysis. Conclusion Serum myonectin is correlated with obesity and increased after laparoscopic sleeve gastrectomy.

scholarly journals In-hospital major adverse outcomes of acute Type A aortic dissection

2018 ◽  
Vol 55 (2) ◽  
pp. 345-350 ◽  
Author(s):  
Jinhua Wei ◽  
Zujun Chen ◽  
Haitao Zhang ◽  
Xiaogang Sun ◽  
Xiangyang Qian ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Type A ◽  
Adverse Outcomes ◽  
Acute Type ◽  
Type A Aortic Dissection

scholarly journals Partial Upper Sternotomy for Extensive arch Repair in Older Acute type A Aortic Dissection Patients

2021 ◽  
Author(s):  
Zhihuang Qiu ◽  
Jun Xiao ◽  
Qingsong Wu ◽  
Tianci Chai ◽  
Li Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Aortic Dissection ◽  
Older Adult ◽  
Early Death ◽  
Type A ◽  
Adult Patients ◽  
Long Term Results ◽  
Acute Type ◽  
Type A Aortic Dissection

Abstract Objectives: The partial upper sternotomy (PUS) approach is acceptable for aortic valve replacement, and even aortic root operation. However, the efficiency of PUS for extensive arch repair of acute type A aortic dissection (AAAD) in older adult patients has not been well investigated.Methods: Between January 2012 and December 2019, 222 older adult patients (≥65 years) diagnosed with AAAD went through extensive arch repair, among which 127 received PUS, and 95 underwent full sternotomy (FS). Logistic regression analysis was used to identify risk factors for early death, and negative binomial regression analysis was applied to explore risk factors related to post-operative ventilator-supporting time and intensive care unit stay time. Results: Total early mortality was 8.1% (18/222 patients). The PUS group had shorter Cardiopulmonary bypass time (133.0 vs.155.0 minutes, P<0.001), cross-clamp time (44.0 vs. 61.0 minutes, P<0.001) and shorter selective cerebral perfusion time (11.0 vs. 21.0 minutes, P<0.001) than the FS group. Left ventricle ejection fraction (LVEF)<50% (odds ratio [OR], 17.05; 95% confidence interval [CI] 1.87-155.63; P=0.012) and malperfusion syndromes (OR, 65.83; 95% CI 11.53-375.86; P<0.001) were related to early death. In the multivariate model, the PUS approach contributed to shorter ventilator-supporting time (incidence rate ratio [IRR], 0.76; 95% CI 0.64-0.91; P=0.003) , when compared with the FS group. Conclusions: The early results of emergency extensive arch repair of AAAD via PUS in older adult patients were satisfactory. However, the long-term results remain to be investigated.

scholarly journals Association of lipid profile parameters, atherogenic index of plasma, anthropometric parameters with the severity of the COVID-19 course in Novosibirsk women

2022 ◽  
Vol 17 (4) ◽  
pp. 20-27
Author(s):  
N. E. Evdokimova ◽  
E. V. Striukova ◽  
N. A. Maslatsov ◽  
A. D. Khudyakova ◽  
M. V. Volkova ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Lipid Profile ◽  
Logistic Regression Analysis ◽  
Hdl Cholesterol ◽  
Atherogenic Index ◽  
Hip Circumference ◽  
Atherogenic Index Of Plasma ◽  
Coronavirus Infection

Background: Our study aimed to assess the relationship between the parameters of the lipid profile, atherogenic index of plasma (AIP), anthropometry influence with the severity of the new coronavirus infection COVID-19 in women. Material and methods. The study design was a cross-sectional study. The research included 138 women aged 29–82 years who had undergone a new coronavirus infection COVID-19 at least two months ago. Participants were divided into three groups by severity of infection: mild (n = 61), moderate (n = 70) and severe (n = 7). Body mass index, waistline and hip circumference, waistline circumference to hip circumference index, total cholesterol, triglycerides, HDL, LDL, AIP were calculated. Statistical processing of the obtained results was carried out using the SPSS software package (version 20.0) using the Mann-Whitney test, univariate logistic regression analysis, Pearson chi-squared test. Results. The levels of HDL-cholesterol were significantly lower in group 3 compared with the level of HDL-cholesterol in women in group 2 (p2-3 = 0.046). BMI was higher in the moderately severe group compared to the mild one (26.32 [23.305; 30.4] versus 28.78 [24.72; 34.77], p1-2 = 0.026). Hip circumference was higher in patients with severe COVID-19 than in patients with mild course (104 [98; 112] versus 114 [109.5; 126], p1-3 = 0.039), AIP was higher in women with severe course compared to women with moderate and mild course (p1-3 = 0.043, p2-3 = 0.04). The results of the logistic regression analysis showed that the moderate course of COVID-19 is associated with BMI (OR = 1.09, 95 % CI 1.019–1.166, p1-2 = 0.012), and the severe course with WC (OR = 1.041, 95 % CI 1.001–1.084, p1-3 = 0.046), AIP value ≥ 0.11 (OR = 13.824, 95 % CI 1.505–126.964, p1-3 = 0.02; OR = 11,579, 95 % CI 1,266–105,219, p2-3 = 0.03) and HDL level < 40 mg/dl (OR = 14,750, 95 % CI 2,317–93,906, p1-3 = 0.004; OR = 8,000, 95 % CI 1,313– 48,538, p1-3 = 0.024). Conclusion. Patients from the group with moderate and severe course of the new coronavirus infection have higher body mass index, hip circumference, AIP, lower HDL values. The chance of a moderate course of COVID-19 is associated with an increased BMI value, and a severe course with WC, AIP ≥ 0.11 and HDL level < 40 mg/dl.

Sign in / Sign up

Export Citation Format

Share Document