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Obesity--a risk factor for postoperative complications in general surgery?
E K M Tjeertes, Elke E K M Tjeertes1, S E Hoeks
1Department of anesthesiology, Erasmus University Medical Centre, Room H-1273, PO Box 2040, 3000, CA, Rotterdam, The Netherlands. e.tjeertes@erasmusmc.nl.
BMC Anesthesiology
|August 1, 2015
Summary
Underweight patients face higher risks of postoperative complications and mortality. Conversely, obesity is linked to improved long-term survival, challenging the notion that it
Area of Science:
- Surgical outcomes research
- Clinical epidemiology
- Obesity medicine
Background:
- The role of body mass index (BMI) in postoperative complications is debated.
- Existing literature lacks conclusive evidence linking obesity to increased surgical risks.
- A BMI-survival paradox has been observed in some patient populations.
Purpose of the Study:
- To investigate the influence of BMI on postoperative complications.
- To determine the impact of BMI on long-term survival after general surgery.
Main Methods:
- Prospective analysis of 4293 general surgery patients.
- Median follow-up of 6.3 years.
- Univariate and multivariate regression models to assess BMI effects on morbidity and mortality.
Main Results:
- Obesity associated with increased wound infection, blood loss, and operation time.
- Underweight patients showed a trend towards higher complication risk.
- Multivariate analysis: underweight patients had worse outcomes (HR 2.1), while overweight/obese patients had improved survival (HR 0.6/0.7).
Conclusions:
- Obesity is a risk factor for specific complications (wound infection, blood loss, operation time) but linked to better long-term survival.
- The obesity paradox is validated in this cohort.
- Underweight patients face the highest risk of major postoperative complications and mortality.
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