Should obese patients not undergo coronary artery surgery?

To assess the effect of obesity on the patient's recovery from coronary artery bypass surgery, a prospective study was performed on 200 patients. Group 1 comprised 101 nonobese patients and group 2, 99 obese patients. The mean percentage over the ideal weight was 8.2% in group 1 and 33.4% in group 2 (p less than 0.001). Preoperative assessment revealed no difference in age, sex, height, incidence of diabetes, family history or smoking habits between the two groups. Group 2 had a higher incidence of hypertension (p less than 0.01) and hyperlipidemia (p less than 0.02). The average number of grafts placed per patient was 3.4 +/- 0.8 in group 1 and 3.5 +/- 0.08 in group 2. Operative mortality was 2.9% and 2.0% in groups 1 and 2 respectively. Obesity was a predictive factor in postoperative hypertension (p less than 0.025), in the development of wound infection (p less than 0.01) and in an increased requirement of bronchodilators (p less than 0.01). The postoperative progression of physical activity and length of hospital stay was similar, being 10.9 +/- 5.8 days and 9.7 +/- 9.5 days in groups 1 and 2 respectively. The authors conclude that bypass grafting is an acceptable therapeutic option for obese patients with coronary artery disease.