Does Elevated Bmi Impact Surgical Outcomes In Congenital Heart Surgery Patients? A Retrospective Study
Hitakshi Modi, MPH, PMP, Abraham Gutierrez, MD, Andrew Well, MD, MPH, MSHCT, Carlos Mery, MD, MPH, Marin Guthrie, BA, Erin Gottlieb, MD, MHCM, Charles Fraser, MD
Dell Medical School - The University of Texas at Austin, Austin, TX, USA.
Background: With pediatric and adult obesity rising in the United States, it is critical to evaluate the impact of Body Mass Index (BMI) on congenital heart surgery outcomes.Methods: Single-center retrospective chart review of patients ≥2years of age between 7/18-8/22. Index surgeries were included. BMI was calculated from height and weight at time of surgery and percentiles for age and sex were calculated for children to categorize patients as underweight, normal, overweight and obese categories. Descriptive, univariate, and multivariable analyses were utilized.Results: Of the total 466 eligible cases identified, 198(42.5%) were female, 184(39.4%) were White non-Hispanic with a median age of 10.6[IQR:5.2-17.30] years and152(32.6%) were either overweight or obese. Overall, 78(16.7%) cases were STAT 3 or greater. In unadjusted analysis BMI category was associated with operative duration, extubation in OR and days intubated (table). However, in multivariable analysis, only Extubation in OR remained significantly associated with Obese BMI category (OR: 0.235, 95% CI: 0.081-0.67, p=0.007).Conclusion: Elevated BMI is common in this population and associated with lower rates of extubation in OR - an important management strategy, particularly in the Fontan operation. Despite this, no differences in other perioperative outcomes were identified. This suggests that despite additional challenges with elevated BMI, favorable surgical outcomes can be achieved. However, these may not be sustainable if BMIs continue to rise. Continued efforts must be made to address the obesity epidemic. 
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