Background: Obesity is suggested to reduce postoperative bleeding in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) but perioperative hemostasis variations have not been studied. Therefore, we investigated the effects of severe obesity (body mass index [BMI] ≥35kg/m(2)) on chest tube output (CTO) and hemostasis in patients undergoing cardiac surgery with CPB.
Materials And Methods: We prospectively investigated 2799 consecutive patients who underwent coronary and/or valve surgery using CPB between 2008 and 2012. 204 patients (7.3%) presented a severe obesity.
Results: In the severe obesity group, the 6-h and 24-h CTO were significantly reduced by -21.8% and -14.8% respectively (P<0.0001) compared with the control group. A significant reduction of the mean number of red blood cell units transfused at 24h was observed in the severe obesity groups (P=0.01). On admission to the intensive care unit, a significant increase of platelet count (+9.2%; P<0.0001), fibrinogen level (+12.2%; P<0.0001) and prothrombin time (+4.1%; P<0.01) and a significant decrease of the activated partial thromboplastin time (-4.2%; P<0.01) were observed in the severe obesity group compared with the control group. In multivariate analysis, severe obesity was significantly associated to a decreased risk of excessive bleeding (24-h CTO >90th percentile; Odds ratio: 0.37, 95% CI: 0.17 to 0.82). No significant differences were observed regarding postoperative thromboembolic events between the two groups.
Conclusions: Severe obesity is associated with a prothrombotic postoperative state that leads to a reduction of postoperative blood loss in patients undergoing cardiac surgery with CPB.
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http://dx.doi.org/10.1016/j.thromres.2014.06.008 | DOI Listing |
Qual Life Res
January 2025
Department of Health Psychology, Faculty of Medical Sciences, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
Purpose: This study aimed to identify trajectories of BMI, obesity-specific health-related quality of life (HR-QoL), and depression trajectories from pre-surgery to 24 months post-bariatric metabolic surgery (BMS), and explore their associations, addressing subgroup differences often hidden in group-level analyses.
Method: Patients with severe obesity (n = 529) reported their HR-QoL and depression before undergoing BMS, and at 12 and 24 months post-operation. Latent Class Growth Analysis was used to identify trajectories of BMI, HR-QoL and depression.
Curr Obes Rep
January 2025
Department of Nutrition Sciences, School of Health Sciences, Ariel University, Ariel, Israel.
Purpose Of Review: Protein intake is recognized as a key nutritional factor crucial for optimizing Metabolic Bariatric Surgery (MBS) outcomes by preventing protein malnutrition, preserving fat-free mass, and inducing satiety. This paper discusses the current evidence regarding protein intake and its impact on clinical outcomes following MBS.
Recent Findings: There are considerable gaps in the understanding of protein requirements following MBS, as existing guidelines are based on limited and inconsistent reports.
Ginekol Pol
January 2025
Department of Obstetrics and Perinatology, Jagiellonian University Medical College, Cracow, Poland, Poland.
Objectives: To evaluate relationship between sFlt-1/PlGF ratio, clinical characteristics and outcomes of pre-eclampsia.
Material And Methods: Retrospective analysis of 29 pregnant women with pre-eclampsia who had measured sFlt-1/PlGF ratio was conducted using electronic medical records from Obstetrics and Perinatology ward of University Hospital in Cracow.
Results: Women median age: 33.
Int J Gynecol Cancer
January 2025
Brigham and Women's Hospital, Department of Obstetrics, Gynecology, and Reproductive Biology, Boston, MA, USA.
Objective: The goal of this study was to evaluate safety after same-day discharge following minimally invasive hysterectomy for endometrial cancer and endometrial intraepithelial neoplasia in patients with and without morbid obesity (body mass index 40 kg/m). Our secondary objective was to identify barriers to same-day discharge.
Methods: Retrospective cohort study of patients undergoing minimally invasive hysterectomy for endometrial cancer and endometrial intraepithelial neoplasia from January 2016 to May 2022.
Swiss Med Wkly
December 2024
Chirurgie Zentrum St. Anna, Hirslanden Hospital, Lucerne, Switzerland.
Aims: A wide range of reproductive health issues, including fertility, pregnancy outcomes and contraceptive practices can be affected by morbid obesity and weight loss subsequent to bariatric surgery. This study aimed to explore the attitudes and practices of bariatric healthcare professionals in Switzerland regarding reproductive health counselling in the context of bariatric surgery.
Methods: We conducted a national, cross-sectional, 36-question online survey among bariatric professionals in Switzerland.
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