BMC Cardiovascular Disorders (Oct 2023)

Impact of body mass index on perioperative mortality of acute stanford type A aortic dissection: a systematic review and meta-analysis

  • Wenyu Song,
  • Jiani Liu,
  • Guowei Tu,
  • Lulu Pan,
  • Yixiang Hong,
  • Lieyang Qin,
  • Lai Wei,
  • Jinmiao Chen

DOI
https://doi.org/10.1186/s12872-023-03517-z
Journal volume & issue
Vol. 23, no. 1
pp. 1 – 10

Abstract

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Abstract Background Obesity may increase perioperative mortality of acute Stanford type A aortic dissection (ATAAD). However, the available evidence was limited. This study aimed to systematically review published literatures about body mass index (BMI) and perioperative mortality of ATAAD. Methods Electronic literature search was conducted in PubMed, Medline, Embase and Cochrane Library databases. All observational studies that investigated BMI and perioperative mortality of ATAAD were included. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a random-effects model. Meta-regression analysis was performed to assess the effects of different clinical variables on BMI and perioperative mortality of ATAAD. Sensitivity analysis was performed to determine the sources of heterogeneity. Egger’s linear regression method and funnel plot were used to determine the publication bias. Results A total of 12 studies with 5,522 patients were eligible and included in this meta-analysis. Pooled analysis showed that perioperative mortality of ATAAD increased by 22% for each 1 kg/m2 increase in BMI (OR = 1.22, 95% CI: 1.10–1.35). Univariable meta-regression analysis indicated that age and female gender significantly modified the association between BMI and perioperative mortality of ATAAD in a positive manner (meta-regression on age: coefficient = 0.04, P = 0.04; meta-regression on female gender: coefficient = 0.02, P = 0.03). Neither significant heterogeneity nor publication bias were found among included studies. Conclusions BMI is closely associated with perioperative mortality of ATAAD. Optimal perioperative management needs to be further explored and individualized for obese patient with ATAAD, especially in elderly and female populations. Trial registration PROSPERO (CRD42022358619). Graphical Abstract BMI and perioperative mortality of ATAAD.

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