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Obese adults and cardiac surgery

Adults with obesity at higher risk of post-op poor cardiac functioning

• 22 percent of obese participants who had heart surgery said they were less able to perform their daily activities within two years of their surgery

There is an association between obesity and postoperative functional decline in survivors of cardiac surgery by age, according to researchers from the University of Pennsylvania who examined information from the University of Michigan Health and Retirement Study. The outcomes were featured in the paper, ‘Association Between Obesity, Age, and Functional Decline in Survivors of Cardiac Surgery, Journal of the American Geriatrics Society’, published in the Journal of the American Geriatrics Society.

Although it is known that obese older adults may be surviving heart surgery with more complications, few researchers have studied how well they can manage daily activities like eating, bathing, walking short distances, dressing, getting in or out of bed, and using the toilet.

To learn more about this key issue, researchers from the University of Pennsylvania focused on 1,731 participants from the study (which included 20,000 participants) who had heart surgery. Of these individuals, 34 percent were obese and 66 percent were not obese. The researchers followed the participants over a two-year period.

The researchers reported that:

  • 22 percent of obese participants who had heart surgery said they were less able to perform their daily activities within two years of their surgery.
  • 17 percent of overweight or normal weight participants who had heart surgery reported that they were less able to perform their daily activities.
  • In the two years following heart surgery, 10.5 percent of obese participants died; 13.8 percent of non-obese participants died.

The multivariable analysis of the full cohort, obesity was not associated with ADL decline (odds ratio (OR)=1.20, 95% confidence interval (CI)=0.90–1.59, p=0.21) after cardiac surgery, although obese respondents aged 50 to 79 had greater odds of ADL decline (OR=1.45, 95% CI=1.06–2.00, p=0.02). Obese respondents aged 80 and older had non-statistically significantly lower odds of ADL decline (OR=0.61, 95% CI=0.30–1.24, p=0.18) compared to non-obese respondents.

The researchers said that obese older adults who survive heart surgery may live with greater degrees of functional decline in the two years following the procedure, especially in participants who were younger than 80-years-old. However, in people aged 80 and older, the relationship between obesity and the ability to function well was considered more complex.

The researchers concluded that additional research is needed to identify interventions to improve outcomes in groups of older adults in whom obesity may increase the risk of postoperative functional decline.

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