Low BMI independent risk factor for increased perioperative RBC transfusion in CABG patients

A recent study BMC Anesthesiology finds the potential risks faced by patients with low body mass index (BMI) undergoing coronary artery bypass grafting (CABG) procedure. 

The research included data from 7,620 patients, revealed intriguing findings. Patients with a BMI less than 18.5 kg/m² were classified as underweight, while those with a BMI between 18.5 and 24.0 kg/m² were considered to have a normal BMI.

One of the study's primary findings was that low BMI significantly increased the risk of red blood cell (RBC) transfusions. This risk was observed in both on-pump and off-pump CABG procedures. Patients with a BMI less than 18.5 kg/m² were approximately four times more likely to require RBC transfusions, as compared to their counterparts with a normal BMI.

Furthermore, the research uncovered distinct risks associated with on-pump CABG procedures for underweight patients. This group exhibited an increased likelihood of post-operative complications, including re-intubation and re-operation. The most concerning revelation was a significantly higher 30-day all-cause mortality rate among underweight patients undergoing on-pump CABG, emphasizing the critical nature of managing these individuals.

These findings have far-reaching implications for the medical community. Surgeons and healthcare systems should carefully consider the BMI of patients before CABG procedures and take measures to minimize the risks associated with low body weight. This may include adjusting surgical techniques, optimizing post-operative care, and closely monitoring underweight patients for potential complications.

The study underscores the need for personalized care in heart surgery, especially for patients with low BMI, and calls for a deeper exploration of strategies to enhance the safety and outcomes of CABG procedures in this specific patient population. It also reinforces the importance of conducting additional research to refine the understanding of how patient characteristics, such as BMI, can impact surgical outcomes.

This study highlights the challenges and risks that underweight patients face in CABG procedures and emphasizes the importance of tailoring medical care to the unique needs of these individuals. By doing so, medical professionals can work to improve the safety and efficacy of heart surgeries for all patients, regardless of their BMI.

Reference:

Gao, J., & Ji, H. (2023). Association of body mass index with perioperative blood transfusion and short-term clinical outcomes in patients undergoing isolated coronary artery bypass grafting. In BMC Anesthesiology (Vol. 23, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12871-023-02329-0