In the present series , overweight and obese patients had similar or slightly lower in-hospital mortality rates after cardiac surgery compared with normal-weight individuals .
Conversely , postoperative complication rates increased with higher BMI levels .
Most studies included in the review showed that overweight and obese patients had at least the same mortality rate as normal-weight patients , or even a lower death risk .
Pooled- data of the meta- analysis provided evidence on the association between higher BMI levels and a lower all-cause in-hospital mortality rate after cardiac surgery
The relationship between higher body mass index ( BMI ) , decreased morbidity and mortality is known as the " obesity paradox " , and has been described in cohorts of patients with hypertension , diabetes , heart failure , coronary and peripheral artery diseases , non-cardiac surgery , and end-stage renal disease .
Here we investigated the relationship between BMI and short-term outcomes after adult cardiac surgery to explore the existence of an obesity paradoxical effect .
A secondary objective was to perform an up date d systematic review to further analyze the association between BMI and 30-day in-hospital mortality after cardiac surgery .
Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old.
BACKGROUND Obesity , defined by a body-mass index ( BMI ) ( the weight in kilograms divided by the square of the height in meters ) of 30.0 or more , is associated with an increased risk of death , but the relation between overweight ( a BMI of 25.0 to 29.9 ) and the risk of death has been question ed . METHODS We prospect ively examined BMI in relation to the risk of death from any cause in 527,265 U.S. men and women in the National Institutes of Health-AARP cohort who were 50 to 71 years old at enrollment in 1995 - 1996 .  BMI was calculated from self-reported weight and height . Relative risks and 95 percent confidence intervals were adjusted for age , race or ethnic group , level of education , smoking status , physical activity , and alcohol intake . We also conducted alternative analyses to address potential biases related to preexisting chronic disease and smoking status . RESULTS During a maximum follow-up of 10 years through 2005 , 61,317 participants ( 42,173 men and 19,144 women ) died  . Initial analyses showed an increased risk of death for the highest and lowest categories of BMI among both men and women , in all racial or ethnic groups , and at all ages . When the analysis was restricted to healthy people who had never smoked , the risk of death was associated with both overweight and obesity among men and women . In analyses of BMI during midlife ( age of 50 years ) among those who had never smoked , the associations became stronger , with the risk of death increasing by 20 to 40 percent among overweight persons and by two to at least three times among obese persons ; the risk of death among underweight persons was attenuated . CONCLUSIONS Excess body weight during midlife , including overweight , is associated with an increased risk of death
In the present series , overweight and obese patients had similar or slightly lower in-hospital mortality rates after cardiac surgery compared with normal-weight individuals .
Conversely , postoperative complication rates increased with higher BMI levels .
Most studies included in the review showed that overweight and obese patients had at least the same mortality rate as normal-weight patients , or even a lower death risk .
Pooled- data of the meta- analysis provided evidence on the association between higher BMI levels and a lower all-cause in-hospital mortality rate after cardiac surgery
The relationship between higher body mass index ( BMI ) , decreased morbidity and mortality is known as the " obesity paradox " , and has been described in cohorts of patients with hypertension , diabetes , heart failure , coronary and peripheral artery diseases , non-cardiac surgery , and end-stage renal disease .
Here we investigated the relationship between BMI and short-term outcomes after adult cardiac surgery to explore the existence of an obesity paradoxical effect .
A secondary objective was to perform an up date d systematic review to further analyze the association between BMI and 30-day in-hospital mortality after cardiac surgery .