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Rethinking Risk in Glossectomy: Obesity and Overweight Status Linked to Fewer Complications and Shorter Hospital
Benjamin Kurnick1,2, Jake L Diamond2, Laurent Ganry1,2
1Division of Oral and Maxillofacial Surgery, Northwell Health, New Hyde Park, New York, USA.
Background:
The obesity paradox suggests higher body mass index (BMI) may improve surgical outcomes despite being a traditional risk factor. This phenomenon has not been evaluated in glossectomy.
Methods:
A retrospective cohort study of 6816 patients undergoing partial or total glossectomy (ACS-NSQIP, 2006-2022) was performed. Patients were stratified by BMI. Outcomes included operative time, length of stay (LOS), 30-day readmission, and complications. Univariate and multivariable analyzes were conducted.
Results:
Obese patients (30.8%) had the shortest LOS (1 day) and lowest complication rate (11.7%) (p < 0.001). Underweight patients (4.0%) had the longest operative time (393 min), LOS (8 days), and highest complication rate (35.9%) (p < 0.001). After adjusting for procedural complexity and covariates, overweight/obese BMI remained independently associated with shorter LOS and lower odds of complications, whereas underweight BMI independently predicted worse outcomes.
Conclusions:
Findings support an obesity paradox in glossectomy, driven primarily by the vulnerability of underweight patients rather than a protective effect of adiposity.
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