Influence of body mass index on outcomes in patients undergoing surgery for diverticular disease

Background: We hypothesized that increasing body mass index is a risk factor for surgical complications in surgery for diverticulitis. We assessed the relationship of body mass index and surgical complications following surgery for diverticular disease. Methods: We used National Surgical Quality Imp...

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Main Authors: Olga Beresneva, Jason Hall
Format: Article
Language:English
Published: Elsevier 2019-10-01
Series:Surgery Open Science
Online Access:http://www.sciencedirect.com/science/article/pii/S2589845019300223
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spelling doaj-39b16ed08e144a2c82246e4304fb48b02020-11-25T03:00:38ZengElsevierSurgery Open Science2589-84502019-10-01128085Influence of body mass index on outcomes in patients undergoing surgery for diverticular diseaseOlga Beresneva0Jason Hall1Corresponding author at: BU/BMC, 88 E. Newton St, C515, Boston, MA 02118. Tel.: +1 215 200 3791.; Boston University/Boston Medical Center, Department of Surgery, 88 East Newton St, C515, Boston, MA 02118Boston University/Boston Medical Center, Department of Surgery, 88 East Newton St, C515, Boston, MA 02118Background: We hypothesized that increasing body mass index is a risk factor for surgical complications in surgery for diverticulitis. We assessed the relationship of body mass index and surgical complications following surgery for diverticular disease. Methods: We used National Surgical Quality Improvement Program database from 2005 to 2015. Patients undergoing surgery for diverticular disease during that period were included and stratified into 9 groups based on their body mass index (<18.5, 18.6–24.9, 25.0–29.9, 30.0–34.9, 35.0–39.9, 40.0–44.9, 45.0–49.9, 50.0–54.9, >55). Outcomes of interest were complications of superficial surgical site infection, deep incisional surgical site infection, organ space surgical site infection, wound disruption complications, pneumonia, ventilator dependence >48 hours, acute renal failure, myocardial infarction, return to operating room, and 30-day mortality. Results: Morbidly obese patients had higher rates of diabetes, hypertension, and steroid use. They had higher American Society of Anesthesiologists classification and were more likely to have emergency and open cases. Interestingly, increased body mass index was inversely associated with age. Increasing body mass index was associated with worse outcomes including superficial surgical site infection, deep incisional surgical site infection, organ space surgical site infection, wound disruption complications, ventilator dependence >48 hours, acute renal failure, and return to operating room. Risk of developing pneumonia didn't have similar correlation with body mass index. Overweight status had protective effect on mortality. No statistically significant differences in increased rates of myocardial infarction were noted. Underweight patients also developed worse outcomes. Conclusion: Obesity is associated with a number of complications following surgery for diverticulitis. Elevated body mass index adds significant risk to procedures for diverticulitis and should be accounted for in risk stratification models. Patients should be counseled on weight reduction before undergoing elective surgery for diverticular disease.http://www.sciencedirect.com/science/article/pii/S2589845019300223
collection DOAJ
language English
format Article
sources DOAJ
author Olga Beresneva
Jason Hall
spellingShingle Olga Beresneva
Jason Hall
Influence of body mass index on outcomes in patients undergoing surgery for diverticular disease
Surgery Open Science
author_facet Olga Beresneva
Jason Hall
author_sort Olga Beresneva
title Influence of body mass index on outcomes in patients undergoing surgery for diverticular disease
title_short Influence of body mass index on outcomes in patients undergoing surgery for diverticular disease
title_full Influence of body mass index on outcomes in patients undergoing surgery for diverticular disease
title_fullStr Influence of body mass index on outcomes in patients undergoing surgery for diverticular disease
title_full_unstemmed Influence of body mass index on outcomes in patients undergoing surgery for diverticular disease
title_sort influence of body mass index on outcomes in patients undergoing surgery for diverticular disease
publisher Elsevier
series Surgery Open Science
issn 2589-8450
publishDate 2019-10-01
description Background: We hypothesized that increasing body mass index is a risk factor for surgical complications in surgery for diverticulitis. We assessed the relationship of body mass index and surgical complications following surgery for diverticular disease. Methods: We used National Surgical Quality Improvement Program database from 2005 to 2015. Patients undergoing surgery for diverticular disease during that period were included and stratified into 9 groups based on their body mass index (<18.5, 18.6–24.9, 25.0–29.9, 30.0–34.9, 35.0–39.9, 40.0–44.9, 45.0–49.9, 50.0–54.9, >55). Outcomes of interest were complications of superficial surgical site infection, deep incisional surgical site infection, organ space surgical site infection, wound disruption complications, pneumonia, ventilator dependence >48 hours, acute renal failure, myocardial infarction, return to operating room, and 30-day mortality. Results: Morbidly obese patients had higher rates of diabetes, hypertension, and steroid use. They had higher American Society of Anesthesiologists classification and were more likely to have emergency and open cases. Interestingly, increased body mass index was inversely associated with age. Increasing body mass index was associated with worse outcomes including superficial surgical site infection, deep incisional surgical site infection, organ space surgical site infection, wound disruption complications, ventilator dependence >48 hours, acute renal failure, and return to operating room. Risk of developing pneumonia didn't have similar correlation with body mass index. Overweight status had protective effect on mortality. No statistically significant differences in increased rates of myocardial infarction were noted. Underweight patients also developed worse outcomes. Conclusion: Obesity is associated with a number of complications following surgery for diverticulitis. Elevated body mass index adds significant risk to procedures for diverticulitis and should be accounted for in risk stratification models. Patients should be counseled on weight reduction before undergoing elective surgery for diverticular disease.
url http://www.sciencedirect.com/science/article/pii/S2589845019300223
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