Introduction:

There is a potentially protective effect of obesity when it coexists with cardiovascular disease, known as the “obesity paradox.” It could be explained by the fact that anthropometric measurements are not a reliable marker of body fat. In this study we propose to estimate body fat with a non-invasive method and study its relationship with morbidity and mortality in cardiac surgery.

Methods:

We conducted a prospective and observational study in adult patients undergoing cardiac surgery. We analyzed demographic, anthropometric and clinical variables along with the estimation of body composition using bioelectric impedance, to study their association to hospitalization days and adverse events after cardiac surgery.

Results:

In the analysis of 98 patients, we found a direct relationship between the percentage of body fat and the length of hospital stay, independent of age, sex, body mass index (BMI) and surgical risk (coefficient of 0.27, p = 0.021). In addition, patients who had mediastinitis showed a significantly higher body fat (31.55 ± 0.64% versus 27.13 ± 7.9%, p <0.001), and patients who died had a tendency to have more fat mass (36.05 ± 3.19% versus 27.20 ± 7.82%, p = 0.08).

Conclusion:

Increased body fat as assessed with BIA was related to morbidity in cardiac surgery. Although this is biologically plausible, it would be necessary to carry out larger studies in order to definitively establish the “BMI paradox”.

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