Impact of obesity on the results of cardiac surgery in Egypt: Early outcomes on heart valve surgery

Background: Rheumatic heart disease is endemic in developing countries, but obesity is worldwide increasing. The aim of this work was to evaluate impact of obesity on the results of heart valve surgery.Methods: This cohort prospective study was conducted on 500 patients with heart valve diseases requiring valve surgery at two centers: Cardiothoracic Surgery Department, Zagazig University Hospitals and General hospital in El Ahrar, Zagazig, Egypt from August 2013 to August 2016. Heart valve surgery patients were subdivided according body mass index (BMI) into 5 groups: non-obese group: BMI < 25; overweight group: BMI 25–29.9; class I obese group: BMI 30–34.9; class II obese group: BMI 35–39.9; and class III obese group: BMI ≥ 40.Collected data were classified into: preoperative,operative, postoperative and follow up data.Results: This study showed that there was no significant difference between the 5 groups regarding the following postoperative outcomes: exploration, arrhythmia, pacemaker insertion, tracheostomy and renal impairment.On the other hand, surgical site infection (SSI) had percentage in the 5 groups as follow: 0.9%, 5.4%, 7.4%, 9.1% and 50% respectively. A highly significant difference was found between non-obese group versus class III obese group, while there was significant difference between overweight group and class I obese group versus class III obese group.Conclusions: This study found no obesity association with higher postoperative morbidity or mortality except for only SSI. So obesity had neutral effect on outcomes and the term Obesity paradox should be changed since the impact of obesity was just a parallax effect