Morbid Obesity Not a Risk for Serious Complications Following Outpatient Surgery

Author:

Tumminello Mariana E.1,Hogan Matthew G.2,Leonardi Claudia3,Barton Jeffrey S.4,Cook Michael W.2,Davis Kurt G.2

Affiliation:

1. Department of Surgery, MedStar Georgetown Washington Hospital Center, Washington, DC, USA

2. Department of Surgery, LSU Health Sciences Center, New Orleans, LA, USA

3. Behavioral and Community Health Sciences, School of Public Health, LSU Health Sciences Center, New Orleans, LA, USA

4. Surgery, Section of Colorectal Surgery, Kaiser Permanente Northwest, Clackamas, OR, USA

Abstract

Patients with class III obesity are often excluded from surgery in ambulatory surgery centers (ASCs). We hypothesize that class III obesity is not a risk factor for serious post-operative complications following outpatient operations. ACS-NSQIP database from 2012 to 2018 was queried. Patients undergoing outpatient inguinal hernia repair (IHR) and laparoscopic cholecystectomy (LC) were grouped by BMI. Baseline characteristics and 30-day outcomes were compared using univariate and multivariate analyses. Of these, 79,916 patients underwent IHR and 107,471 patients underwent LC. Multivariable analysis in IHR showed increased odds of superficial SSIs in all classes of obesity compared to normal weight ( P < .0001). In the LC group, there were higher rates of SSIs with obesity ( P < .0001). For both surgeries, a higher rate of readmissions to the hospital were observed in class II and IIIa obesity (both P < .0001), although rates were relatively low (<3%). Class III obesity demonstrates a statistically significant increase in SSI following IHR and LC. Severe complications requiring readmission are not mirrored, suggesting the morbidly obese patients should be considered for routine surgical procedures in outpatient settings.

Publisher

SAGE Publications

Subject

General Medicine

Reference15 articles.

1. Growth of Ambulatory Surgical Centers, Surgery Volume, and Savings to Medicare

2. ASA Physical Status Classification System | American Society of Anesthesiologists (ASA). 2020. Available at: Asahq.org Accessed September 18, 2020.

3. The Morbidly Obese Patient Undergoing Outpatient Surgery

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