TY - JOUR
T1 - Albumin is a better predictor of outcomes than body mass index following coronary artery bypass grafting
AU - Bhamidipati, Castigliano M.
AU - Lapar, Damien J.
AU - Mehta, Gaurav S.
AU - Kern, John A.
AU - Upchurch, Gilbert R.
AU - Kron, Irving L.
AU - Ailawadi, Gorav
N1 - Funding Information:
Supported by T32/HL007849 grant from the National Heart, Lung, and Blood Institute (C.M.B., D.J.L.) and a grant from the Thoracic Surgery Foundation for Research and Education Research Grant (G.A.).
PY - 2011/10
Y1 - 2011/10
N2 - Objective: Body mass index (BMI) influences risk in coronary artery bypass grafting (CABG) patients, but albumin level is not collected by the Society of Thoracic Surgeons database. We postulate that preoperative albumin is a better predictor of mortality than BMI following CABG. Methods: BMI from patients with serum albumin level within 6 months of isolated CABG during 1995-2010 from our institutional databases were identified. Patients were stratified by National Heart, Lung, and Blood Institute (NHLBI) BMI class, and by preoperative albumin. Regression models were used to assess predictors of morbidity and mortality. Results: We analyzed 2,794 isolated CABG patients at our institution. Unadjusted mortality was highest with lowest BMI (P ≤.05), and in patients with 2-3 g/dL albumin (P =.02). Ejection fraction (EF) and intra-aortic balloon pump (IABP) use were similar despite BMI; however, EF was lowest and IABP use highest in the 2-3 g/dL albumin group (P <.001, respectively). Unlike BMI groups, increasing albumin was associated with lower major complication rates (P =.001). Similarly, adjusted mortality was not influenced by BMI (AOR 0.97, 95% CI 0.93-1.02), but increasing albumin levels reduced the adjusted odds of death (AOR 0.61, 95% CI 0.42-0.90). Conclusion: Albumin, more than body mass index, is associated with mortality and morbidity in isolated CABG recipients and may be a better indicator for outcomes.
AB - Objective: Body mass index (BMI) influences risk in coronary artery bypass grafting (CABG) patients, but albumin level is not collected by the Society of Thoracic Surgeons database. We postulate that preoperative albumin is a better predictor of mortality than BMI following CABG. Methods: BMI from patients with serum albumin level within 6 months of isolated CABG during 1995-2010 from our institutional databases were identified. Patients were stratified by National Heart, Lung, and Blood Institute (NHLBI) BMI class, and by preoperative albumin. Regression models were used to assess predictors of morbidity and mortality. Results: We analyzed 2,794 isolated CABG patients at our institution. Unadjusted mortality was highest with lowest BMI (P ≤.05), and in patients with 2-3 g/dL albumin (P =.02). Ejection fraction (EF) and intra-aortic balloon pump (IABP) use were similar despite BMI; however, EF was lowest and IABP use highest in the 2-3 g/dL albumin group (P <.001, respectively). Unlike BMI groups, increasing albumin was associated with lower major complication rates (P =.001). Similarly, adjusted mortality was not influenced by BMI (AOR 0.97, 95% CI 0.93-1.02), but increasing albumin levels reduced the adjusted odds of death (AOR 0.61, 95% CI 0.42-0.90). Conclusion: Albumin, more than body mass index, is associated with mortality and morbidity in isolated CABG recipients and may be a better indicator for outcomes.
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U2 - 10.1016/j.surg.2011.07.056
DO - 10.1016/j.surg.2011.07.056
M3 - Article
C2 - 22000173
AN - SCOPUS:80054113930
SN - 0039-6060
VL - 150
SP - 626
EP - 634
JO - Surgery
JF - Surgery
IS - 4
ER -