Association between preoperative body mass index and postoperative short-term outcomes in patients undergoing...

Pancreaticoduodenectomy (PD) is regarded as a highly complex procedures with high morbidity. This study aims to investigate the association between preoperative body mass index (BMI) and postoperative short-term outcomes in patients after PD.

Patients enrolled in this multicenter study were categorized into three groups based on preoperative BMI: low-BMI group (BMI <18.5 kg/m²), normal-BMI group (18.5≤ BMI <25.0 kg/m²), and high-BMI group (BMI ≥25.0 kg/m²). The baseline characteristics, intraoperative variables, and short-term postoperative outcomes of the patients were compared. Univariable and multivariable analyses were conducted to identify the risk factors for mortality and morbidity following PD.

Among the 658 patients, 64 (9.7%), 475 (72.2%), and 119 (18.1%) were low-BMI, normal-BMI, and high-BMI, respectively. Compared with normal-BMI group, the mortality and morbidity were significantly higher in the low-BMI group (6.3% vs. 1.5%, P=0.03; 64.1% vs. 49.3%, P<0.001) and high-BMI group (5.0% vs. 1.5%, P=0.03; 67.2% vs. 49.3%, P<0.001). Multivariable analyses revealed that both low-BMI and high-BMI were independently associated with increased mortality [odds ratio (OR) 4.220, 95% confidence interval (CI): 1.133-15.712, P=0.03, and OR 4.046, 95% CI: 1.262-12.976, P=0.02] and overall morbidity (OR 2.084, 95% CI: 1.135-3.827, P=0.02, and OR 2.364, 95% CI: 1.462-3.822, P<0.001). Similar results were also observed for the incidence of clinically relevant postoperative pancreatic fistula (CR-POPF).

Patients with low-BMI and high-BMI had elevated postoperative mortality and morbidity, as well as an increased risk of CR-POPF following PD.