Body mass index and postoperative mortality in patients undergoing coronary artery bypass graft surgery plus valve replacement: a retrospective cohort study

BACKGROUND: The relationship between body mass index (BMI) and postoperative mortality in patients who undergo coronary artery bypass graft (CABG) surgery plus valve replacement is uncertain. We aimed to investigate the association between body mass index (BMI) and postoperative mortality among patients who simultaneously underwent both CABG surgery plus valve replacement. METHODS: We retrospectively analyzed 1976 patients who underwent CABG surgery at our hospital between January 2017 and April 2021, including 202 patients who underwent valve replacement surgery during the same period. We analyzed the relationship between BMI and postoperative mortality. The relationship between BMI and postoperative mortality was assessed using smooth curve fitting and a Multiple logistic regression model. RESULTS: The results of smoothing curve fitting showed that BMI and postoperative mortality had a non-linear relationship, and the resulting curve exhibited a two-stage change and a breakpoint. Postoperative mortality is higher in patients that have a body mass index above 25 kg/m(2) compared to patients having a body mass index between 18 and 25 kg/m(2). CONCLUSIONS: Our study found a non-linear relationship between BMI and postoperative mortality in patients undergoing CABG plus valve replacement after adjusting for potential confounders. The causal relationship between BMI and postoperative mortality still requires further investigations.