Obese less likely to die after heart operations

The results of a British Heart Foundation-funded research has revealed that patients who are overweight are less likely to die in hospital after a heart operation than those who are a healthy weight.

Published in the Circulation journal, data collected from 400,000 adults by a team at the University of Leicester suggests that it is wrong to deny patients surgery based on them being overweight, and instead claims that underweight patients could benefit from gaining weight prior to a heart operation - representing an ‘obesity paradox’, having both destructive and protective effects.

Of the 400,000 adults who underwent cardiac surgery between 2002 and 2013, 11,511 patients died in hospital. This included 4.4 per cent of patients who were of healthy weight, compared with only 2.8 per cent of those who were overweight and 2.7 per cent in obese class I, which is those with a BMI of 30 to 35.

The researchers claim that data from patients in other areas across Europe, the United States and Asia were met with similar conclusions.

Prof Jeremy Pearson, BHF’s associate medical director, said: “We always recommend a healthy waistline, which significantly reduces lifetime risk of heart disease and therefore a person’s risk of needing cardiac surgery. However, this large study strongly suggests that being overweight can give patients added protection when facing major heart surgery, reducing their chance of complications or death before leaving hospital.”

Gavin Murphy, BHF professor of cardiac surgery at the University of Leicester, added: “We saw a 25 per cent reduction in death by being overweight as opposed to being normal [healthy] weight. That’s a bigger effect on mortality than statins.

“It changes one of the most basic approaches behind surgery, which is that people need to lose weight before surgery. Obese patients are generally considered unfit for surgery. This study shows the very morbidly obese – with a BMI greater than 40 – did not have a greater risk. It shows that no patient should be rejected for surgery on the basis of body mass.”