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Correlation Between Body Mass Index (BMI) and Postoperative Complications in Elective General Surgery: A Multicenter
Yashar Mashayekhi1, Muhammad Idrees Shabbir2, Sara Baba-Aissa3
1Medicine, Leicester University Hospital, Leicester, GBR.
Cureus
|October 22, 2025
Summary
Extremes in body mass index (BMI), especially obesity, increase the risk of 30-day postoperative complications in general surgery. Preoperative BMI assessment is crucial for surgical risk stratification and reducing patient morbidity.
Area of Science:
- Surgical Outcomes Research
- Nutritional Status Assessment
- Public Health & Epidemiology
Background:
- Body mass index (BMI) is a key indicator of nutritional status with established links to surgical outcomes.
- Both obesity and underweight are associated with increased risks of adverse postoperative events.
Purpose of the Study:
- To evaluate the association between body mass index (BMI) and 30-day postoperative complications.
- To determine how BMI categories correlate with the incidence, type, and severity of surgical complications.
Main Methods:
- A cross-sectional, multicenter study involving 355 adult patients undergoing elective general surgery.
- Patients were categorized by WHO BMI classifications, and postoperative complications were graded using the Clavien-Dindo system.
Main Results:
- Postoperative complication rates were highest in obese (36.4%) and underweight (25.0%) patients compared to normal-weight individuals (18.5%).
- Surgical site infections (10.7%), pulmonary complications (5.9%), and wound dehiscence (4.2%) were the most frequent complications.
- Obese patients experienced significantly longer operative times and hospital stays.
Conclusions:
- Elevated BMI, particularly obesity, is linked to increased postoperative complication rates in elective general surgery.
- Integrating preoperative BMI assessment into surgical risk stratification is recommended.
- Targeted strategies to optimize BMI are essential for reducing surgical morbidity.
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