Mehmet AKSÜT, Ekin Can ÇELİK, Deniz GÜNAY, Tanıl ÖZER, Mustafa Mert ÖZGÜR, Mehmet Kaan KIRALİ

Beden Kitle İndeksi ile İzole Koroner Baypas Cerrahisi Sonrası Beklenen Göğüs Tüpü Drenajı Arasındaki Negatif Korelasyon

Giriş: Obezitenin insanlık için iyi bilinen bir tehdit unsuru olduğu kanıtlanmış bir gerçektir. Ancak yıllar içinde yapılan birtakım araştırmalarda obezitenin belirli durumlarda koruyucu rolü olduğu gibi çelişik durumlar gözlemlenmiştir. Bu çalışmada artmış beden kitle indeksi (BKİ) değerleri ile koroner arter baypas greftleme (KABG) cerrahisi sonrası göğüs tüpü drenajı arasındaki ilişkiyi ortaya koymayı amaçladık. Hastalar ve Yöntem: Aralık 2015-Aralık 2016 tarihleri arasında, izole KABG operasyonu geçirmiş 421 hastanın verileri retrospektif olarak tarandı. BKİ değerleri, Amerikan Kalp Derneği ve Dünya Sağlık Örgütü tarafından belirlenen alt sınıflara gruplandırıldı. Bu alt gruplar; zayıf (< 20 kg/m2), normal (20-25 kg/m2), fazla kilolu (25-30 kg/m2), obez (30-35 kg/m2) ve morbid obez (> 35 kg/m2) olarak kabul edildi. Postoperatif göğüs tüpü drenaj değeri KABG sonrası ilk 24 saatte ölçülen değer olarak kaydedildi. Bulgular: Çalışmaya katılan ortalama hasta yaşı 61.6 ± 1.06 idi. Hasta popülasyonunun çoğunluğunu 251 (%59.6) hasta ile erkekler oluşturmaktaydı. Hastalar önce kabaca obez (> 30 kg/m2) (n= 136) ve non-obez (< 30 kg/m2) (n= 193) olmak üzere iki gruba ayrıldı. Obez olmayan grupta postoperatif ortalama göğüs tüpü drenaj miktarı 630 ± 360 mL iken, obez hasta grubunda 463 ± 303 mL bulundu. BKİ ile KABG sonrası göğüs tüpü drenajı arasındaki ilişkinin analizi için bağımsız t-test kullanıldı. Test sonucunda ortaya çıkan ilişki istatistiksel olarak anlamlı idi. Bunun üzerine ileri analiz amaçlı olarak KABG sonrası göğüs tüpü drenajının beş farklı BKİ alt grubu ile ilişkisini değerlendirmeye karar verdik. Bunun için varyans analizi (ANOVA) yapıldı ve sonuçların istatistiksel olarak anlamlı olduğu görüldü. Sonuç: BKİ ile KABG sonrası göğüs tüpü drenajı arasında negatif bir korelasyon bulunmaktadır. BKİ’nin ileride planlanabilecek kanama öngörü skorlarında kullanılabileceğini düşünmekteyiz.

Anahtar Kelimeler:

Beden kitle indeksi, obezite, kanama, drenaj, kardiyak cerrahi, koroner arter baypas

Negative Correlation Between Body Mass Index and Chest Tube Out-put After Coronary Artery Bypass Graft Surgery

Introduction: The obvious threat of obesity to human life is well-known, but some contradictory outcomes have been encountered during previous medical research. Interestingly, obesity was recognized as a protective factor for some specific obesity-related situations. We aimed to correlate increased body mass index (BMI) and chest tube out-put after coronary artery bypass grafting (CABG). Patients and Methods: We retrospectively collected data of 421 patients who underwent isolated CABG surgery between dates of December 2015 and December 2016. Obtained BMI values were grouped into: underweight (< 20 kg/m2 ), normal weight (20-25 kg/m2 ), overweight (25-30 kg/m2 ), obese (30-35 kg/m2 ), and severely obese (> 35 kg/m2 ) subclasses. The postoperative chest tube output volume corresponded drainage at first 24 hours after the CABG surgery. Results: The mean age was 61.6 (± 1.06) years. Female to male ratio was found 40, 9/59, 6 (n= 170/251). The patient population was divided into 2 groups as BMI below and above 30 kg/m2 to approximately evaluate the relation between BMI and chest tube out-put. Overall, 193 patients were in the non-obese group, and 136 patients were in the obese group. The mean drainage amounts of non-obese and obese groups were 630 ± 360 and 463 ± 303 mL, respectively. We ran independent t-test to evaluate the relationship between BMI and chest tube out-put. It was statistically significant. The relationship between drainage and five different BMI subgroups was evaluated. Analysis of variance (ANOVA) showed statistically significant chest tube output difference between the normal and obese groups as well as the severely obese group. Conclusion: BMI is negatively correlated with bleeding after CABG surgery and should be considered in future bleeding prediction systems.

Keywords:

Body mass index, obesity, bleeding, chest tube out-put, cardiac surgery, coronary artery bypass surgery,

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ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi