Title |
The Effect of Body Mass Index on Perioperative Outcomes After Major Surgery: Results from the National Surgical Quality Improvement Program (ACS‐NSQIP) 2005–2011
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Published in |
World Journal of Surgery, June 2015
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DOI | 10.1007/s00268-015-3112-7 |
Pubmed ID | |
Authors |
Akshay Sood, Firas Abdollah, Jesse D. Sammon, Kaustav Majumder, Marianne Schmid, James O. Peabody, Mark A. Preston, Adam S. Kibel, Mani Menon, Quoc‐Dien Trinh |
Abstract |
Obesity is associated with poor surgical outcomes and disparity in access-to-care. There is a lack of quality data on the effect of body mass index (BMI) on perioperative outcomes. Accordingly, we sought to determine the procedure specific, independent-effect of BMI on 30-day perioperative outcomes in patients undergoing major surgery. Participants included individuals undergoing one of 16 major surgery (cardiovascular, orthopedic, oncologic; n = 141,802) recorded in the ACS-NSQIP (2005-2011). Outcomes evaluated included complications, blood transfusion, length-of-stay (LOS), re-intervention, readmission, and perioperative mortality. Multivariable-regression models assessed the independent-effect of BMI on outcomes. Nearly, 74 % of patients had a BMI disturbance; the majority being overweight (35.3 %) or obese (29.8 %). Morbidly obese patients constituted a small but significant proportion of the patients (5.7 %; n = 8067). In adjusted-analyses, morbidly obese patients had significantly increased odds of wound complications in 15 of the examined procedures, of renal complications after 6-procedures, of thromboembolism after 5-procedures, of pulmonary, septic and UTI complications after 2-procedures, and of cardiovascular complications after CABG. Conversely, obese/overweight patients, except for increased odds of wound complications after select procedures, had significantly decreased odds of perioperative mortality, prolonged-LOS and blood transfusion relative to normal BMI patients after 4, 8, and 9 of the examined procedures. The prevalence of BMI derangements in surgical patients is high. The effect of BMI on outcomes is procedure specific. Patients with BMI between 18.5 and 40-kg/m(2) at time of surgery fare equally well with regard to complications and mortality. However, morbidly obese patients are at-risk for postsurgical complications and targeted preoperative-optimization may improve outcomes and attenuate disparity in access-to-care. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 66 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Other | 10 | 15% |
Student > Bachelor | 8 | 12% |
Student > Doctoral Student | 7 | 11% |
Researcher | 6 | 9% |
Professor | 3 | 5% |
Other | 10 | 15% |
Unknown | 22 | 33% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 35 | 53% |
Agricultural and Biological Sciences | 2 | 3% |
Mathematics | 1 | 2% |
Nursing and Health Professions | 1 | 2% |
Psychology | 1 | 2% |
Other | 3 | 5% |
Unknown | 23 | 35% |