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Differences in acute general surgical admissions between obese or overweight patients compared to normal-sized
1Senior Lecturer, Department of Surgery, University of Otago Christchurch, Consultant General Surgeon, Christchurch Hospital. richard.flint@otago.ac.nz.
Aim:
Obesity is changing the pattern of modern health and illness. Despite its adverse effect on medical ailments such as diabetes and ischaemic heart disease, its effect on acute general surgical conditions is unknown. This study aims to determine the effect that excess weight and obesity have on acute general surgical conditions.
Methods:
A prospective observational cohort study comparing the pattern of acute general surgical admissions in patients with a BMI >25 kg/m(2) to those with a normal BMI from a single tertiary-level hospital.
Results:
There were 2,676 (21.5%) patients who were overweight or obese (mean BMI 32.4 ± 6.3 kg/m(2)). These patients were significantly younger than those with normal BMI (48.3 ± 18.1 years versus 50.5 ± 22.4 years; p<0.0001). They had a shorter average hospital stay (2.9 ± 4.2 compared to 3.2 ± 5.0 days; p=0.14). However, more overweight patients required a visit to theatre (34% compared to 29%; p<0.0001, OR 1.25 (1.14 to 1.37; 95% CI)). Overweight patients were more likely to suffer from biliary conditions (13% compared to 8%; p<0.0001; OR 1.84 (1.60-2.10)) and pancreatitis (6% compared to 4 %; p<0.0001; OR 1.71 (1.42 to 2.06)). In contrast, they were less likely to present with bowel obstruction (4% compared to 6%; p<0.0001, OR 0.63 (0.5 to 0.78)) or GI bleeding (4% compared to 6%; p<0.0001; OR 0.64 (0.51 to 0.79)).
Conclusions:
Overweight or obese patients present at a younger age and with a higher predominance of gallstone related diseases.
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