The Effect of Body Mass Index on Postoperative Bleeding and Blood Transfusion in Patients with Coronary Bypass Surgery

Abstract

Objectives: The use of blood and blood products, which is a major complication, significantly increases the durationof stay in intensive care and hospitalization, as well as hospital costs on open heart surgery. In our study, we aimed toinvestigate the relationship between postoperative early bleeding, blood and blood product use in coronary arterybypass grafting (CABG) surgery under cardiopulmonary bypass (CPB).Methods: In this study, 843 patients who underwent consecutive CABG operation between May 2012 and March2014 were included. The patients were classified into three categories according to their body mass index (BMI); weakgroup (BMI ≤19 kg/m2), normal weight group (BMI 20-29 kg/m2) and obese group (BMI ≥30 kg/m2). Preoperatively; age,gender, height, weight, diabetes mellitus (DM), hypertension, hyperlipidemia, chronic obstructive pulmonary disease(COPD), preoperative myocardial infarction, left ventricular ejection fraction (LVEF), mean hemoglobin and platelet values, Intraoperatively; cross clamp time, cardiopulmonary bypass time, total duration of the operation, amount of cardioplegia given, number of grafts used in coronary bypass. Postoperatively; the total amount of blood used, drainageamount, given vasopressor treatment, given positive inotropic support, intraaortic balloon pump usage, intubationduration, intensive care stay, hospital stay, bleeding-related re-exploration and mortality of all patients were examined.Results: It was observed that more blood transfusions performed in patients with low and normal weight comparedto the obese group (11.22±2.85 ml/kg, p=0.011). Also in patients with low and normal weight compared to the obesegroup more blood loss was observed (7.12±1.87 ml/kg, p=0.017).Conclusion: In our study, in accordance with the general opinion of previous studies, we found that patients with highBMI had lower postoperative blood loss and blood use than patients with low BMI.