Body mass index and the risk of postoperative complications with dentoalveolar surgery: a prospective study

Obesity is a disease that affects millions of Americans. Sixty-nine million Americans are considered to be overweight including at least 1 in 5 children. Overweight and obesity as risk factors for complications associated with dentoalveolar surgery have not been extensively studied. The purpose of this study was to prospectively investigate the frequency and the nature of postoperative complications in obese patients receiving ambulatory dentoalveolar surgery.

Patients undergoing dentoalveolar outpatient ambulatory surgery at the University of Cincinnati Oral and Maxillofacial Surgery Clinic from January 10, 2005 to December 7, 2005 were enrolled in a prospective study. At the preoperative visit, height, weight, and age were recorded. The body mass index (BMI) was calculated and patients were divided into weight categories based on CDC and WHO classifications. Unfavorable outcomes studied included number of postoperative visits, infections, alveolar osteitis, soft and hard tissue problems, and postoperative bleeding. Complication categories were created for all complications identified during postoperative exams and t tests were performed to see if increased BMI correlated to higher postoperative complication rates, if multiple complications correlated to increased BMI, and to see if individual postoperative complication groups and BMI correlated. Because it was thought that complications would increase the number of postoperative exams for a particular patient, simple linear regression was used to see if BMI correlated to increased number of postoperative visits.

No significant differences were noted in number of postoperative complications when comparing patients' BMIs (t = -0.62, P = .5350). Simple linear regression analysis showed that increased BMI did not predict increased number of postoperative visits. Increased age was the only predictor of increased postoperative complication risk (t = -3.17, P = .0016) and of increased number of postoperative visits (t = -16.35, P < .0001, and P < .0001 by nonparametric Wilcoxon rank sum test).

The BMI is not statistically correlated to higher postoperative complication rates or increased number of postoperative visits. Obesity remains an important risk factor for dentoalveolar ambulatory outpatient anesthesia; however, it is not associated with poorer postoperative complication rates.