Author:
Kassahun Woubet Tefera,Mehdorn Matthias,Babel Jonas
Abstract
Abstract
Background
Obesity has been shown to increase the rates of morbidity and occasionally mortality in patients undergoing nonbariatric elective surgery. However, little is known about the impact of obesity on outcomes after surgery for high-risk abdominal emergencies.
Methods
A single-center retrospective evaluation of outcomes in high-risk abdominal emergency patients categorized by body mass index (BMI) was conducted. Patient demographics, comorbidities, and operative details were analyzed. Patients with normal weight (BMI 18.5–24.9) served as comparators. Multivariable linear and logistic regression analyses were performed to assess the impact of obesity on surgical outcomes.
Results
In total, 886 patients with BMI < 18.5 (underweight; n = 50), 18.5–24.9 (normal weight; n = 306), 25–29.9 (overweight; n = 336) and ≥ 30 (obese; n = 194) based on the World Health Organization (WHO) weight classification criteria met the inclusion criteria. Compared to normal-weight patients, patients with overweight and obesity were older and more likely to be male. The rates of comorbidity (100% vs 91.2%, p = < 0.0001), morbidity (77.8% vs 65.6%, p = 0.003), and in-hospital mortality (44.8% vs 30.4%, p = 0.001) were all higher in patients with obesity than in normal-weight patients. Patients with obesity had an increased intensive care unit length of stay (ICU LOS) (13 days vs 9 days, p = 0.019) and hospital LOS (21.4 days vs 18.1 days, p = 0.081) and prolonged ventilation (39.1% vs 19.6%, p = 0.003). As BMI deviated from the normal range, the morbidity and mortality rates increased incrementally, with the highest morbidity (87.9%) and mortality (54.5%) rates observed in morbidly obese patients (BMI ≥ 40).
Conclusions
Patients with obesity were the most likely to have coexisting conditions, experience postoperative complications, and die during the first admission following EL for high-risk abdominal emergencies.
Publisher
Springer Science and Business Media LLC
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