BACKGROUND: Obesity is an important health problem in cardiac surgery and among patients requiring postcardiotomy venoarterial extracorporeal membrane oxygenation (V-A ECMO). Still, whether these patients are at risk for unfavorable outcomes after postcardiotomy V-A ECMO remains unclear. The current study evaluated the association between body mass index (BMI) and in-hospital outcomes in this setting. METHODS: The Post-cardiotomy Extracorporeal Life Support (PELS-1) study is an international, multicenter study. Patients requiring postcardiotomy V-A ECMO in 36 centers from 16 countries between 2000 and 2020 were included. Patients were divided in 6 BMI categories (underweight, normal weight, overweight, class I, class II, and class III obesity) according to international recommendations. Primary outcome was in-hospital mortality, and secondary outcomes included major adverse events. Mixed logistic regression models were applied to evaluate associations between BMI and mortality. RESULTS: The study cohort included 2046 patients (median age, 65 years; 838 women [41.0%]). In-hospital mortality was 60.3%, without statistically significant differences among BMI classes for in-hospital mortality (P = .225) or major adverse events (P = .126). The crude association between BMI and in-hospital mortality was not statistically significant after adjustment for comorbidities and intraoperative variables (class I: odds ratio [OR], 1.21; 95% CI, 0.88-1.65; class II: OR, 1.45; 95% CI, 0.86-2.45; class III: OR, 1.43; 95% CI, 0.62-3.33), which was confirmed in multiple sensitivity analyses. CONCLUSIONS: BMI is not associated to in-hospital outcomes after adjustment for confounders in patients undergoing postcardiotomy V-A ECMO. Therefore, BMI itself should not be incorporated in the risk stratification for postcardiotomy V-A ECMO.

Beijing Anzhen Hospital Capital Medical University Beijing China

Cardiac Thoracic and Vascular Department Niguarda Hospital Milan Italy

Cardiothoracic Department University Hospital of Udine Udine Italy

Centre of Applied Medical Research St Vincent's Hospital Darlinghurst New South Wales Australia; University of New South Wales Sidney New South Wales Australia

Department of Cardiothoracic Surgery Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht Maastricht the Netherlands

Department of Cardiovascular Sciences University Hospitals Leuven University of Leuven Leuven Belgium

Department of Intensive Care Medicine and Care and Public Health Research Institute Maastricht the Netherlands

ECMO Unit Departamento de Anestesia Clínica Las Condes Las Condes Santiago Chile

Erasmus MC Rotterdam the Netherlands

Faculty of Medicine Siriraj Hospital Mahidol University Bangkok Thailand

Fundación Cardiovascular de Colombia Bucaramanga Colombia

General University Hospital and 1st Faculty of Medicine Charles University Prague Prague Czech Republic

Heinrich Heine University Düsseldorf Germany

Indiana University Methodist Hospital Indianapolis Indiana

IRCCS ISMETT Palermo Italy

Istituto di Ricovero e Cura a Carattere Scientifico Azienda Ospedaliero Universitaria di Bologna Bologna Italy

Istituto di Ricovero e Cura a Carattere Scientifico Humanitas Research Hospital Rozzano Milan Italy

Johns Hopkins Hospital Baltimore Maryland

Korea University College of Medicine Seoul South Korea

Leipzig Heart Centre Leipzig Germany

Louis Pradel Cardiologic Hospital Lyon France

Medical University of Vienna Vienna Austria

Memorial Healthcare System Hollywood Florida

National University Heart Centre National University Hospital Singapore Singapore

Ospedale del Cuore Fondazione Toscana G Monasterio Massa Italy

Pontchaillou University Hospital Rennes France

San Gerardo Hospital University of Milano Bicocca Monza Italy; Department of Medicine and Surgery University of Parma Parma Italy; Cardiac Surgery Unit University Hospital of Parma Parma Italy

Strutture Organizzative Dipartimentali Cardiochirurgia Ospedali Riuniti 'Umberto 1 Lancisi Salesi' Università Politecnica delle Marche Ancona Italy

The Alfred Hospital Melbourne Victoria Australia

The Prince Charles Hospital Brisbane Queensland Australia

University Hospital Henri Mondor Créteil Paris France

University Medical Centre Regensburg Regensburg Germany

University of Maryland Baltimore Maryland

Vilnius University Hospital Santariskiu Klinikos Vilnius Lithuania

Ziekenhuis Oost Limburg Genk Belgium

Ann Thorac Surg. 2023 Jul;116(1):154-155. doi: 10.1016/j.athoracsur.2023.04.010. PubMed

Citace poskytuje Crossref.org

Characteristics and Outcomes of Prolonged Venoarterial Extracorporeal Membrane Oxygenation After Cardiac Surgery: The Post-Cardiotomy Extracorporeal Life Support (PELS-1) Cohort Study