Bariatric surgery may be considered for CABG patients with a BMI >35 kg/m2 if lifestyle interven- tions have already been attempted without meaning- ful weight loss (Class IIb; Level of Evidence C). Nutrition The nutritional status of patients plays an important role in the results after CABG. Approximately 20% of patients have been identified as having poor preoperative nutritional sta- tus before undergoing cardiac surgery.410 Several nutritional screening tools exist, including the Malnutrition Universal Screening Tool. When the Malnutrition Universal Screening Tool score is added to the EuroSCORE in a multivariable model evaluating perioperative risk, the prediction of the model for both postoperative complications and mortal- ity is significantly improved compared with the use of the Preoperative malnutrition, whether defined on the basis of a nutritional screening tool or serum albumin level, has been shown to predict adverse postopera- tive events such as reoperation for bleeding, postoperative renal failure, prolonged ventilatory support, vasopressor treatment for >11 days, antibiotic treatment for >21 days, intensive care unit stay, total length of stay, increased inflam- matory response, infection, positive blood cultures, and It is well established that BMI decreases after major surgery such as CABG. DiMaria-Ghalili413 assessed 91 patients under- going CABG and observed a 5% change between the preop- erative BMI level and the level measured 4 to 6 weeks after surgery. This finding corresponded to a 13.8% decrease in self-reported physical health during the same time period. At a mean follow-up of 19 months, this same investigator observed that older patients undergoing elective CABG usually did not regain the weight they lost between the preoperative period and after hospital discharge. 