Ata Niyazi ECEVİT, Özgür ALTINBAŞ, Cengiz GÜVEN

Koroner Arter Baypas Greft Operasyonu Yapılan Obez ve Morbid Obez Hastaların Karşılaştırılması

Amaç: Obezite ve morbid obezite gelişmekte olan ülkelerde önemli bir halk sağlığı sorunu olarak toplumu tehdit etmektedir. Bununla birlikte bir çok obez veya morbid obez hastada koroner arter hastalığı nedeniyle koroner arter baypas greftleme operasyonuna ihtiyaç duyulmaktadır. Biz de bu çalışmada kliniğimizde koroner arter baypas greftleme yaptığımız obez ve morbid obez hastaları retrospektif olarak inceleyerek bu hastalarda mortalite ve morbiditeyi artıran risk faktörlerini karşılaştırmayı amaçladık. Yöntem . 2008 ile 2014 yılları arasında kliniğimizde koroner arter hastalığı nedeni ile takip edilen obez ve morbid obez hastalardan koroner arter baypas greftleme uygulanan hastaları retrospesfik olarak inceledik. Belirtilen yıllar arasında 593 hastaya koroner arter baypas greftleme uygulanmıştı. Bu hastalar obez (n=69) ve morbid obez (n=68) olmalarına göre iki gruba ayrıldı. Morbid obez hastaların vücut kitle indeksleri 35 kg/m2 ve vücut yüzey alanları 2.0 kg/m2 ‘nin üzerinde idi. Obez hastaların ise vücut kitle indeksleri 25-35 kg/m2 ve vücut yüzey alanları 1.8-2.0 kg/m2 arasındaydı. Bulgular: Hastaların median yaşları obez hasta grubunda 61,20±9,04, morbid obez hasta grubunda 60,54±10,65 idi. Obez hasta grubunda diabetes mellitus 32 (%46,4), morbid obez hasta grubunda ise 20 (% 29,4) hastada mevcuttu (p=0.041). Anstabil anjina pektoris şikayeti olan hasta sayısı obez hasta grubunda 20(% 29) morbid obez hasta grubunda ise 10(%14,7)'du (p=0.043). Hastanede kalış süresi obez hasta grubunda 10 gün morbid obez hasta grubunda ise 12 gün idi. 30 günlük mortalite her iki grupta eşit olmakla birlikte % 4,4 idi. Sonuç: Morbid obez ile obez hastalar karşılatırıldığında morbid obez olanlarda koroner arter baypas greftleme için artmış mortalite ve morbiditeye sebep olacak risk faktörleri olmadığı düşünülmektedir.

Anahtar Kelimeler:

koroner arter baypas greft operasyonu, obezite, morbid obezite

Comparison of Obese and Morbidly Obese Patients Underwent Coronary Artery Bypass Graft Operations

Aim: Obesity and morbid obesity threatens society as a major public health problem in developing countries. However, for many obese or morbidly obese patients, coronary artery bypass grafting operation is needed due to coronary artery disease. In this study, we aimed to evaluate the risk factors which increase mortality and morbidity in these obese and morbidly obese patients underwent coronary artery bypass grafting in our clinic.Materials and methods: Obese and morbidly obese patients underwent coronary artery bypass grafting due to coronary artery disease in our clinic between 2008 and 2014 were analyzed retrospectively. 593 patients underwent coronary artery bypass grafting between the years specified. They were divided into two groups as obese (n=69) and morbid obese (n=68) patient. Each morbid obese patients has a body mass index more than 35 kg/m2 and a body surface area more than 2.0 kg/m2. Each obese patients has a body mass indexes between 25-35 kg/m2 and a body surface area between 1.8-2.0 kg/m2. Results: The median age of the patients was 61,20±9.04 in the obese patient group and 60,54±10,65 in morbid obese patient group. Diabetes mellitus was present in 32(46,4%) patients in obese patient group, and in 20( 29,4%) patients in morbid obese patient group (p=0.041). The number of patients with complaints of chest pain was 20(29%) in the obese patient group and 10(14.7%) in morbid obese patient group (p=0.043). Duration of hospital stay was 12 days in obese patient group and 10 days in morbid obese patient group. 30-day mortality was equal in both groups with 4.4%. Conclusion. According to our study there was not any risk factor which can increase mortality and morbidity in morbid obese patients when they compared with obese patients

Keywords:

Coronary artery by-pass grafting, morbid obesity, obesity,

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