Can BMI be a predictor of perioperative complications in Head and Neck cancer surgery?

Abstract

Context: The effect of BMI on development of perioperative complications in head and neck cancer surgeries is not well-defined. Aims: This study aims to evaluate the effect of body mass index (BMI) on the development of surgical complications during the perioperative period in head & neck carcinoma (HNC) patients. Settings and Design: Retrospective analytical study Methods and Material: This study was conducted from 2019 to 2020. Electronic medical records of 210 patients undergoing major (clean-contaminated) surgeries were analysed. Statistical analysis used: Chi-square test or Fisher exact test for determining association in categorical data and independent T-test or Mann-Whitney U test for comparison between the presence of complication and relation with continuous clinical parameters were used. Results: The majority of patients were within normal-weight (68.57%). Only 12.85% patients had BMI under 18.5 kg/m2 and 18.57% patients had BMI equal to or more than 25 kg/m2. The coexisting comorbidities were present in 48.7% patients with BMI more than 25 kg/m2. In all patients, major and minor complications were present in 10.5% and 16.7% patients, respectively. Surgical site infections were present in 18.1% patients. There was no statistical difference in the rate of complication (major, minor and SSI) in underweight, normal weight and overweight categories. The complications was significantly associated with the extent of surgery (p=0.00413) and blood loss of more than 775 ml (p-value 0.005). Conclusions: In conclusion, the rate of surgical complication in head and neck onco-surgeries is not related to BMI of the patients. The perioperative management of these patients might require some modification due to co-existing comorbidities, but the overall impact on development on complication could not be proven in this study.