Post-operative obesity and cachexia are risk factors for morbidity and mortality after heart transplant: Multi-institutional study of post-operative weight change

Kathleen L. Grady, David Naftel, Salpy V. Pamboukian, O. H. Frazier, Paul Hauptman, John Herre, Howard Eisen, Frank Smart, Robert Bourge

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Background: The relationship between post-heart transplant cachexia and obesity with subsequent morbidity and mortality has not yet been reported. Therefore, the purposes of this study were to: (1) describe change in body mass index (BMI) from before transplant through 5 years after transplant; (2) identify risk factors for increased BMI at 1 year post-transplant; and (3) determine whether post-transplant BMI is associated with post-transplant morbidity and mortality. Methods: Patients (n = 3,540) were from a non-random sample having received a heart transplant between January 1, 1996 and December 31, 2001 at 33 institutions of the Cardiac Transplant Research Database (CTRD). Patients were divided into groups using cut-offs for categories of BMI. Data were assessed according to frequencies, measures of central tendency, Pearson correlations, chi-square tests, multiple regression and stratified actuarial analyses with log-rank tests for comparisons. The level of statistical significance was set at p = 0.05. Results: The number of obese patients increased significantly from immediately before heart transplant to 5 years later (17% vs 38%) (p < 0.0001). Risk factors for increased BMI at 1 year after heart transplant (explaining 56% of variance) included increased BMI at transplant, younger age, black race, non-ischemic etiology of heart disease, Status I at time of transplant and non-use of mycophenolate mofetil. Patients who were underweight or obese at 1 year post-transplant were at greater risk for rejection over time than patients who were of normal weight or overweight (p = 0.009). Conclusions: Both demographic and clinical factors are related to increased BMI at 1 year after heart transplantation. Post-transplant cachexia and obesity are risk factors for poor clinical outcomes after heart transplantation.

Original languageEnglish (US)
Pages (from-to)1424-1430
Number of pages7
JournalJournal of Heart and Lung Transplantation
Volume24
Issue number9
DOIs
StatePublished - Sep 1 2005

Fingerprint

Cachexia
Obesity
Morbidity
Transplants
Weights and Measures
Mortality
Body Mass Index
Heart Transplantation
Actuarial Analysis
Mycophenolic Acid
Thinness
Chi-Square Distribution

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

Cite this

Grady, Kathleen L. ; Naftel, David ; Pamboukian, Salpy V. ; Frazier, O. H. ; Hauptman, Paul ; Herre, John ; Eisen, Howard ; Smart, Frank ; Bourge, Robert. / Post-operative obesity and cachexia are risk factors for morbidity and mortality after heart transplant : Multi-institutional study of post-operative weight change. In: Journal of Heart and Lung Transplantation. 2005 ; Vol. 24, No. 9. pp. 1424-1430.
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title = "Post-operative obesity and cachexia are risk factors for morbidity and mortality after heart transplant: Multi-institutional study of post-operative weight change",
abstract = "Background: The relationship between post-heart transplant cachexia and obesity with subsequent morbidity and mortality has not yet been reported. Therefore, the purposes of this study were to: (1) describe change in body mass index (BMI) from before transplant through 5 years after transplant; (2) identify risk factors for increased BMI at 1 year post-transplant; and (3) determine whether post-transplant BMI is associated with post-transplant morbidity and mortality. Methods: Patients (n = 3,540) were from a non-random sample having received a heart transplant between January 1, 1996 and December 31, 2001 at 33 institutions of the Cardiac Transplant Research Database (CTRD). Patients were divided into groups using cut-offs for categories of BMI. Data were assessed according to frequencies, measures of central tendency, Pearson correlations, chi-square tests, multiple regression and stratified actuarial analyses with log-rank tests for comparisons. The level of statistical significance was set at p = 0.05. Results: The number of obese patients increased significantly from immediately before heart transplant to 5 years later (17{\%} vs 38{\%}) (p < 0.0001). Risk factors for increased BMI at 1 year after heart transplant (explaining 56{\%} of variance) included increased BMI at transplant, younger age, black race, non-ischemic etiology of heart disease, Status I at time of transplant and non-use of mycophenolate mofetil. Patients who were underweight or obese at 1 year post-transplant were at greater risk for rejection over time than patients who were of normal weight or overweight (p = 0.009). Conclusions: Both demographic and clinical factors are related to increased BMI at 1 year after heart transplantation. Post-transplant cachexia and obesity are risk factors for poor clinical outcomes after heart transplantation.",
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Post-operative obesity and cachexia are risk factors for morbidity and mortality after heart transplant : Multi-institutional study of post-operative weight change. / Grady, Kathleen L.; Naftel, David; Pamboukian, Salpy V.; Frazier, O. H.; Hauptman, Paul; Herre, John; Eisen, Howard; Smart, Frank; Bourge, Robert.

In: Journal of Heart and Lung Transplantation, Vol. 24, No. 9, 01.09.2005, p. 1424-1430.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Post-operative obesity and cachexia are risk factors for morbidity and mortality after heart transplant

T2 - Multi-institutional study of post-operative weight change

AU - Grady, Kathleen L.

AU - Naftel, David

AU - Pamboukian, Salpy V.

AU - Frazier, O. H.

AU - Hauptman, Paul

AU - Herre, John

AU - Eisen, Howard

AU - Smart, Frank

AU - Bourge, Robert

PY - 2005/9/1

Y1 - 2005/9/1

N2 - Background: The relationship between post-heart transplant cachexia and obesity with subsequent morbidity and mortality has not yet been reported. Therefore, the purposes of this study were to: (1) describe change in body mass index (BMI) from before transplant through 5 years after transplant; (2) identify risk factors for increased BMI at 1 year post-transplant; and (3) determine whether post-transplant BMI is associated with post-transplant morbidity and mortality. Methods: Patients (n = 3,540) were from a non-random sample having received a heart transplant between January 1, 1996 and December 31, 2001 at 33 institutions of the Cardiac Transplant Research Database (CTRD). Patients were divided into groups using cut-offs for categories of BMI. Data were assessed according to frequencies, measures of central tendency, Pearson correlations, chi-square tests, multiple regression and stratified actuarial analyses with log-rank tests for comparisons. The level of statistical significance was set at p = 0.05. Results: The number of obese patients increased significantly from immediately before heart transplant to 5 years later (17% vs 38%) (p < 0.0001). Risk factors for increased BMI at 1 year after heart transplant (explaining 56% of variance) included increased BMI at transplant, younger age, black race, non-ischemic etiology of heart disease, Status I at time of transplant and non-use of mycophenolate mofetil. Patients who were underweight or obese at 1 year post-transplant were at greater risk for rejection over time than patients who were of normal weight or overweight (p = 0.009). Conclusions: Both demographic and clinical factors are related to increased BMI at 1 year after heart transplantation. Post-transplant cachexia and obesity are risk factors for poor clinical outcomes after heart transplantation.

AB - Background: The relationship between post-heart transplant cachexia and obesity with subsequent morbidity and mortality has not yet been reported. Therefore, the purposes of this study were to: (1) describe change in body mass index (BMI) from before transplant through 5 years after transplant; (2) identify risk factors for increased BMI at 1 year post-transplant; and (3) determine whether post-transplant BMI is associated with post-transplant morbidity and mortality. Methods: Patients (n = 3,540) were from a non-random sample having received a heart transplant between January 1, 1996 and December 31, 2001 at 33 institutions of the Cardiac Transplant Research Database (CTRD). Patients were divided into groups using cut-offs for categories of BMI. Data were assessed according to frequencies, measures of central tendency, Pearson correlations, chi-square tests, multiple regression and stratified actuarial analyses with log-rank tests for comparisons. The level of statistical significance was set at p = 0.05. Results: The number of obese patients increased significantly from immediately before heart transplant to 5 years later (17% vs 38%) (p < 0.0001). Risk factors for increased BMI at 1 year after heart transplant (explaining 56% of variance) included increased BMI at transplant, younger age, black race, non-ischemic etiology of heart disease, Status I at time of transplant and non-use of mycophenolate mofetil. Patients who were underweight or obese at 1 year post-transplant were at greater risk for rejection over time than patients who were of normal weight or overweight (p = 0.009). Conclusions: Both demographic and clinical factors are related to increased BMI at 1 year after heart transplantation. Post-transplant cachexia and obesity are risk factors for poor clinical outcomes after heart transplantation.

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