Effect of obesity on postoperative outcomes in patients with left ventricular assist device
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We congratulate Volkovicher and colleagues for their successful study . We found the main outcome of their study very interesting that obesity is not a risk factor for mortality in patients with left ventricular assist device (LVAD). Even as the authors have briefly stated in the discussion section, obesity does not seem to be a risk factor for mortality in similar studies with LVAD patients [2, 3]. However, this does not exactly coincide with our current knowledge of the general outcome of the cardiac surgery. Because obesity is described as a risk factor for mortality in many studies involving cardiac surgery without any LVAD patient [4, 5, 6]. In many of these studies, apart from mortality rate, the negative effects of obesity on many parameters such as re-hospitalization, the incidence of postoperative surgical infection, prolonged duration of stay in the intensive care unit, prolonged ventilation, and the incidence of postoperative renal failure have been reported. In the authors’ study, obesity does not seem to be a problem in terms of mortality and many of these parameters. But, the remarkable expression in these studies we have exemplified is “extreme obesity”. So, the main issue mentioned in these studies is extremely high body mass index (BMI). In fact, in the authors’ study, mortality rate is also seen to increase somewhat as the BMI increases. Is not there too much generalization in this context while reporting that obesity has no effect on mortality? Would not it be more appropriate to emphasize that the situation is different in obese patients with morbid obesity? We believe that learning about the authors’ ideas on this subject will add value to their study.
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Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Volkovicher N, Kurihara C, Critsinelis A, Kawabori M, Sugiura T, Manon M 2nd, Civitello AB, Morgan JA. Effect of obesity on outcomes in patients undergoing implantation of continuous-flow left ventricular assist devices. J Artif Organs. https://doi.org/10.1007/s10047-017-1013-2.
- 5.Syrakas CA, Neumaier-Prauser P, Angelis I, Kiask T, Kemkes BM, Gansera B. Is extreme obesity a risk factor for increased in-hospital mortality and postoperative morbidity after cardiac surgery? Results of 2251 obese patients with BMI of 30 to 50. Thorac Cardiovasc Surg. 2007;55:491–3.CrossRefPubMedGoogle Scholar