The Influence Of Body Mass Index On Early Clinical Outcomes After Valve Replacement

Objective:Retrospectively analyzed the influence of body mass index(BMI)on early clinical outcomes after valve replacement.Methods:To collect clinical data,patients hospitalized for surgical valve replacement due to rheumatic heart valve disease,including body mass index(BMI)between 2019 and2021.According to body mass index(kg/m~2),divided into four subgroups:low weight group(BMI≤18.5kg/m~2),normal weight group(BMI18.5-23.9kg/m~2),overweight group(BMI24-27.9kg/m~2)and obesity group(BMI≥28kg/m~2).A linear regression model was used to analyze the postoperative hospital stay and postoperative ICU stay days.The influence factors of in-hospital mortality were analyzed using univariate and multivariate logistic regression analysis.Results:In this analysis of 355 patients undergoing surgical valve replacement.There was no statistical difference in age among the groups,P=0.075.At the same time,compared with other groups,there were more female patients in the low body weight group,P<0.001.In the analysis of mortality during postoperative hospitalization,the data analysis showed that there was a"J"type relationship between BMI and the results of the study,and there was a statistically significant difference in mortality during postoperative hospitalization between different BMI groups,P<0.001,and further.The analysis found that mortality was highest in the low-weight group.A negative impact of low BMI on early clinical outcomes in postoperative patients was found.And overweight and obese patients also had shorter postoperative hospital stay and postoperative ICU stay.However,in terms of postoperative wound infection rate,the obese group was significantly higher than the low-weight group(P=0.015)and the normal weight group(P=0.003).It was confirmed that overweight and obesity have a certain protective effect on early clinical outcomes of postoperative patients compared with normal weight and low weight patients.In the regression model,BMI≤18.5kg/m~2(OR 11.137,P=0.046)was an independent risk factor for in-hospital mortality,and increased with age(OR 1.176,P<0.001),female patients(OR 3.516,P=0.030),postoperative incision bleeding(OR 6.152,P=0.012),and postoperative dialysis(OR7.186,P=0.008)were independent risk factors for in-hospital mortality.Conclusions:A"J"-shaped relationship was found between body mass index and in-hospital mortality in patients undergoing surgical valve replacement.Patients with low BMI had a higher mortality rate than normal,overweight and obese patients.It shows that in patients undergoing surgical treatment,in addition to paying attention to the risk of cardiovascular disease in obese and overweight patients,the early clinical outcomes of patients with low body mass index,especially elderly women with BMI≤18.5Kg/m~2,are worthwhile.We pay more attention to the perioperative nutritional management of such patients is particularly important.