Body Mass Index is a Useful Predictor of Prognosis After Left Ventricular Assist System Implantation
Background The obesity paradox has recently attracted considerable interest in the study of many diseases. In this investigation we examine the relationship between body mass index (BMI) and prognosis after left ventricular assist system (LVAS) implantation. Methods We measured the BMI of 64 patient...
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| Veröffentlicht in: | The Journal of heart and lung transplantation 2009-05, Vol.28 (5), p.428-433 |
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| creator | Mano, Akiko, MD, PhD Fujita, Kiyoharu Uenomachi, Kaori Kazama, Keiichi Katabuchi, Mayumi, RN Wada, Kyoichi, BS Terakawa, Nobue, BS Arai, Koji Hori, Yumiko, RN Hashimoto, Syuji Nakatani, Takeshi, MD, PhD Kitamura, Soichiro, MD, PhD |
| description | Background The obesity paradox has recently attracted considerable interest in the study of many diseases. In this investigation we examine the relationship between body mass index (BMI) and prognosis after left ventricular assist system (LVAS) implantation. Methods We measured the BMI of 64 patients 3 months after LVAS implantation for end-stage heart failure. The patients were classified according to BMI into Group A (BMI 1 year) mortality was significantly higher in Group A than in Groups B and C (59% vs 40% and 18%, respectively; p < 0.05). The incidence of sepsis was also significantly higher in Group A than in Groups B and C (68% vs 45% and 32%, respectively; p < 0.05). After multivariate adjustment, BMI |
| doi_str_mv | 10.1016/j.healun.2008.12.020 |
| format | Article |
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In this investigation we examine the relationship between body mass index (BMI) and prognosis after left ventricular assist system (LVAS) implantation. Methods We measured the BMI of 64 patients 3 months after LVAS implantation for end-stage heart failure. The patients were classified according to BMI into Group A (BMI <16 kg/m2 ), Group B (BMI 16 to 18.4 kg/m2 ) or Group C (BMI ≥18.5 kg/m2 ). We compared the prognosis among these three groups after a mean follow-up period of 583 days. Results Seven patients were weaned from their LVAS, 24 received heart transplantation, 25 died on the transplant waiting list, and 8 remain on the list. Long-term (>1 year) mortality was significantly higher in Group A than in Groups B and C (59% vs 40% and 18%, respectively; p < 0.05). The incidence of sepsis was also significantly higher in Group A than in Groups B and C (68% vs 45% and 32%, respectively; p < 0.05). After multivariate adjustment, BMI <16 kg/m2 (hazard ratio [HR] 14.9; 95% confidence interval [CI] 2.61 to 86.0; p < 0.01) and levels of C-reactive protein (HR 1.56; 95% CI 1.15 to 2.13; p < 0.01) were independent predictors of mortality. Conclusions A lower BMI indicated a poor prognosis, as well as a higher incidence of a fatal complication, sepsis, after LVAS implantation. Control of BMI could be an effective way to improve management of patients with LVAS.]]></description><identifier>ISSN: 1053-2498</identifier><identifier>EISSN: 1557-3117</identifier><identifier>DOI: 10.1016/j.healun.2008.12.020</identifier><identifier>PMID: 19416769</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Body Mass Index ; C-Reactive Protein - metabolism ; Cardiology. Vascular system ; Child ; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care ; Female ; Follow-Up Studies ; Heart Failure - mortality ; Heart Failure - surgery ; Heart Transplantation ; Heart-Assist Devices ; Humans ; Intensive care medicine ; Male ; Medical sciences ; Middle Aged ; Postoperative Complications - mortality ; Prognosis ; Proportional Hazards Models ; Risk Factors ; Sepsis - mortality ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Survival Rate</subject><ispartof>The Journal of heart and lung transplantation, 2009-05, Vol.28 (5), p.428-433</ispartof><rights>International Society for Heart and Lung Transplantation</rights><rights>2009 International Society for Heart and Lung Transplantation</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c511t-6c69f50438ee7a846b325ee43e96db80c4bb4200655630cbaaa8fb6b614f3a353</citedby><cites>FETCH-LOGICAL-c511t-6c69f50438ee7a846b325ee43e96db80c4bb4200655630cbaaa8fb6b614f3a353</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1053249808018135$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21479555$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19416769$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mano, Akiko, MD, PhD</creatorcontrib><creatorcontrib>Fujita, Kiyoharu</creatorcontrib><creatorcontrib>Uenomachi, Kaori</creatorcontrib><creatorcontrib>Kazama, Keiichi</creatorcontrib><creatorcontrib>Katabuchi, Mayumi, RN</creatorcontrib><creatorcontrib>Wada, Kyoichi, BS</creatorcontrib><creatorcontrib>Terakawa, Nobue, BS</creatorcontrib><creatorcontrib>Arai, Koji</creatorcontrib><creatorcontrib>Hori, Yumiko, RN</creatorcontrib><creatorcontrib>Hashimoto, Syuji</creatorcontrib><creatorcontrib>Nakatani, Takeshi, MD, PhD</creatorcontrib><creatorcontrib>Kitamura, Soichiro, MD, PhD</creatorcontrib><title>Body Mass Index is a Useful Predictor of Prognosis After Left Ventricular Assist System Implantation</title><title>The Journal of heart and lung transplantation</title><addtitle>J Heart Lung Transplant</addtitle><description><![CDATA[Background The obesity paradox has recently attracted considerable interest in the study of many diseases. In this investigation we examine the relationship between body mass index (BMI) and prognosis after left ventricular assist system (LVAS) implantation. Methods We measured the BMI of 64 patients 3 months after LVAS implantation for end-stage heart failure. The patients were classified according to BMI into Group A (BMI <16 kg/m2 ), Group B (BMI 16 to 18.4 kg/m2 ) or Group C (BMI ≥18.5 kg/m2 ). We compared the prognosis among these three groups after a mean follow-up period of 583 days. Results Seven patients were weaned from their LVAS, 24 received heart transplantation, 25 died on the transplant waiting list, and 8 remain on the list. Long-term (>1 year) mortality was significantly higher in Group A than in Groups B and C (59% vs 40% and 18%, respectively; p < 0.05). The incidence of sepsis was also significantly higher in Group A than in Groups B and C (68% vs 45% and 32%, respectively; p < 0.05). After multivariate adjustment, BMI <16 kg/m2 (hazard ratio [HR] 14.9; 95% confidence interval [CI] 2.61 to 86.0; p < 0.01) and levels of C-reactive protein (HR 1.56; 95% CI 1.15 to 2.13; p < 0.01) were independent predictors of mortality. Conclusions A lower BMI indicated a poor prognosis, as well as a higher incidence of a fatal complication, sepsis, after LVAS implantation. Control of BMI could be an effective way to improve management of patients with LVAS.]]></description><subject>Adolescent</subject><subject>Adult</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Body Mass Index</subject><subject>C-Reactive Protein - metabolism</subject><subject>Cardiology. Vascular system</subject><subject>Child</subject><subject>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - surgery</subject><subject>Heart Transplantation</subject><subject>Heart-Assist Devices</subject><subject>Humans</subject><subject>Intensive care medicine</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Postoperative Complications - mortality</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Risk Factors</subject><subject>Sepsis - mortality</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><subject>Survival Rate</subject><issn>1053-2498</issn><issn>1557-3117</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkk2r1DAUhoso3g_9ByLZ6K413203wnjR68CIwvW6DWl6ohnbZExScf69KTMouHGVhPO-57x5OFX1jOCGYCJf7ZtvoKfFNxTjriG0wRQ_qC6JEG3NCGkfljsWrKa87y6qq5T2GGPKBH1cXZCeE9nK_rIa34TxiD7olNDWj_ALuYQ0uk9glwl9ijA6k0NEwZZH-OpDKvWNzRDRDmxGX8Dn6Mwy6Yg2qRQzujumDDPazodJ-6yzC_5J9cjqKcHT83ld3b97-_nmfb37eLu92exqIwjJtTSytwJz1gG0uuNyYFQAcAa9HIcOGz4MvPxWCiEZNoPWurODHCThlmkm2HX18tT3EMOPBVJWs0sGphIEwpKUbEnfUkKLkJ-EJoaUIlh1iG7W8agIVitdtVcnumqlqwhVhW6xPT_3X4YZxr-mM84ieHEW6GT0ZKP2xqU_Okp42wuxBn190kGh8dNBVMk48KbgjmCyGoP7X5J_G5jJeVdmfocjpH1Yoi-kFVGpGNTdugnrIuAOk44UVL8B2Zqu_g</recordid><startdate>20090501</startdate><enddate>20090501</enddate><creator>Mano, Akiko, MD, PhD</creator><creator>Fujita, Kiyoharu</creator><creator>Uenomachi, Kaori</creator><creator>Kazama, Keiichi</creator><creator>Katabuchi, Mayumi, RN</creator><creator>Wada, Kyoichi, BS</creator><creator>Terakawa, Nobue, BS</creator><creator>Arai, Koji</creator><creator>Hori, Yumiko, RN</creator><creator>Hashimoto, Syuji</creator><creator>Nakatani, Takeshi, MD, PhD</creator><creator>Kitamura, Soichiro, MD, PhD</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20090501</creationdate><title>Body Mass Index is a Useful Predictor of Prognosis After Left Ventricular Assist System Implantation</title><author>Mano, Akiko, MD, PhD ; Fujita, Kiyoharu ; Uenomachi, Kaori ; Kazama, Keiichi ; Katabuchi, Mayumi, RN ; Wada, Kyoichi, BS ; Terakawa, Nobue, BS ; Arai, Koji ; Hori, Yumiko, RN ; Hashimoto, Syuji ; Nakatani, Takeshi, MD, PhD ; Kitamura, Soichiro, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c511t-6c69f50438ee7a846b325ee43e96db80c4bb4200655630cbaaa8fb6b614f3a353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Body Mass Index</topic><topic>C-Reactive Protein - metabolism</topic><topic>Cardiology. Vascular system</topic><topic>Child</topic><topic>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - surgery</topic><topic>Heart Transplantation</topic><topic>Heart-Assist Devices</topic><topic>Humans</topic><topic>Intensive care medicine</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Postoperative Complications - mortality</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Risk Factors</topic><topic>Sepsis - mortality</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mano, Akiko, MD, PhD</creatorcontrib><creatorcontrib>Fujita, Kiyoharu</creatorcontrib><creatorcontrib>Uenomachi, Kaori</creatorcontrib><creatorcontrib>Kazama, Keiichi</creatorcontrib><creatorcontrib>Katabuchi, Mayumi, RN</creatorcontrib><creatorcontrib>Wada, Kyoichi, BS</creatorcontrib><creatorcontrib>Terakawa, Nobue, BS</creatorcontrib><creatorcontrib>Arai, Koji</creatorcontrib><creatorcontrib>Hori, Yumiko, RN</creatorcontrib><creatorcontrib>Hashimoto, Syuji</creatorcontrib><creatorcontrib>Nakatani, Takeshi, MD, PhD</creatorcontrib><creatorcontrib>Kitamura, Soichiro, MD, PhD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of heart and lung transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mano, Akiko, MD, PhD</au><au>Fujita, Kiyoharu</au><au>Uenomachi, Kaori</au><au>Kazama, Keiichi</au><au>Katabuchi, Mayumi, RN</au><au>Wada, Kyoichi, BS</au><au>Terakawa, Nobue, BS</au><au>Arai, Koji</au><au>Hori, Yumiko, RN</au><au>Hashimoto, Syuji</au><au>Nakatani, Takeshi, MD, PhD</au><au>Kitamura, Soichiro, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Body Mass Index is a Useful Predictor of Prognosis After Left Ventricular Assist System Implantation</atitle><jtitle>The Journal of heart and lung transplantation</jtitle><addtitle>J Heart Lung Transplant</addtitle><date>2009-05-01</date><risdate>2009</risdate><volume>28</volume><issue>5</issue><spage>428</spage><epage>433</epage><pages>428-433</pages><issn>1053-2498</issn><eissn>1557-3117</eissn><abstract><![CDATA[Background The obesity paradox has recently attracted considerable interest in the study of many diseases. In this investigation we examine the relationship between body mass index (BMI) and prognosis after left ventricular assist system (LVAS) implantation. Methods We measured the BMI of 64 patients 3 months after LVAS implantation for end-stage heart failure. The patients were classified according to BMI into Group A (BMI <16 kg/m2 ), Group B (BMI 16 to 18.4 kg/m2 ) or Group C (BMI ≥18.5 kg/m2 ). We compared the prognosis among these three groups after a mean follow-up period of 583 days. Results Seven patients were weaned from their LVAS, 24 received heart transplantation, 25 died on the transplant waiting list, and 8 remain on the list. Long-term (>1 year) mortality was significantly higher in Group A than in Groups B and C (59% vs 40% and 18%, respectively; p < 0.05). The incidence of sepsis was also significantly higher in Group A than in Groups B and C (68% vs 45% and 32%, respectively; p < 0.05). After multivariate adjustment, BMI <16 kg/m2 (hazard ratio [HR] 14.9; 95% confidence interval [CI] 2.61 to 86.0; p < 0.01) and levels of C-reactive protein (HR 1.56; 95% CI 1.15 to 2.13; p < 0.01) were independent predictors of mortality. Conclusions A lower BMI indicated a poor prognosis, as well as a higher incidence of a fatal complication, sepsis, after LVAS implantation. Control of BMI could be an effective way to improve management of patients with LVAS.]]></abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>19416769</pmid><doi>10.1016/j.healun.2008.12.020</doi><tpages>6</tpages></addata></record> |
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| subjects | Adolescent Adult Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Body Mass Index C-Reactive Protein - metabolism Cardiology. Vascular system Child Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care Female Follow-Up Studies Heart Failure - mortality Heart Failure - surgery Heart Transplantation Heart-Assist Devices Humans Intensive care medicine Male Medical sciences Middle Aged Postoperative Complications - mortality Prognosis Proportional Hazards Models Risk Factors Sepsis - mortality Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Survival Rate |
| title | Body Mass Index is a Useful Predictor of Prognosis After Left Ventricular Assist System Implantation |
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