2-046 Mass index classifications and their associations with short-term outcomes of surgical aortic valve replacement

<h3>Introduction</h3> Several cardiovascular procedures, like transcatheter aortic valve implantation(TAVI), have shown an obesity paradox. However, limited data exists regarding the impact of body mass index (BMI) on patients undergoing surgical aortic valve replacement(SAVR), particularly among underweight cases. This study aims to conduct a BMI- stratified analysis of short-term outcomes following SAVR. <h3>Methods</h3> Procedures of SAVR were extracted using the National Inpatient Sample(2016–2022). We stratified our cohort based on BMI into underweight, normal, overweight, and obese. Keeping the normal BMI cohort as a reference, we evaluated the differences in short-term outcomes. <h3>Results</h3> In this study, we considered 3150(3.7%) patients with normal BMI, while there were 2300(2.7%), 12325(14.3%), and 68425(79.4%) classified as underweight, overweight, and obese respectively. We found that underweight patients had higher odds of sepsis, post-procedural respiratory failure(PPRF), cardiogenic shock(CS), acute kidney injury requiring hemodialysis(AKI+HD), and all-cause mortality than normal BMI cases. Meanwhile, obese and overweight patients expressed lower odds of sepsis, major bleeding, and CS than the normal BMI group. Furthermore, overweight patients also had lower odds of PPRF, and AKI+HD (vs. normal BMI), while obese patients had lower odds of post-procedural cerebrovascular event(PPCE)(vs. normal BMI). <h3>Conclusion</h3> In patients undergoing SAVR, obese and overweight individuals paradoxically experienced a lower risk for several complications, while underweight patients faced a higher risk.