High and low body mass index and 90-day postoperative outcomes in patients with Crohn's disease undergoing abdominal

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Daniel Shaham1, Shira Naveh2, Meir Zemel2

  • 1IBD Unit, Department of Gastroenterology and Liver Diseases, Tel Aviv Sourasky Medical Center, Israel; Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.

American Journal of Surgery
|July 2, 2026
PubMed

Insights

Underweight patients with Crohn's disease (CD) face significantly higher risks of postoperative complications and longer hospital stays. Preoperative nutritional support is crucial for improving outcomes in this vulnerable group.

Area of Science:

  • Gastroenterology
  • Surgical Outcomes
  • Nutritional Science

Background:

  • Crohn's disease (CD) management often involves surgery.
  • Body Mass Index (BMI) is a key indicator of nutritional status.
  • Postoperative outcomes can be influenced by patient health metrics.

Purpose of the Study:

  • To investigate the association between Body Mass Index (BMI) categories and 90-day postoperative outcomes in patients with Crohn's disease (CD).
  • To identify if underweight or obesity impacts surgical recovery in CD patients.

Main Methods:

  • Retrospective cohort study of 271 CD patients undergoing abdominal surgery from 2017-2019.
  • Patients were classified into underweight (BMI <18.5), normal/overweight (18.5-30), and obese (>30) groups.
  • Primary outcomes included 90-day overall and severe complications (Clavien-Dindo >2) and total length of stay (LOS).

Main Results:

  • Underweight status (n=64) was independently linked to increased overall complications (OR=2.0), severe complications (OR=3.05), and longer LOS (beta=3.43).
  • Obesity (n=18) showed a trend towards higher morbidity but lacked independent significance after multivariable adjustment (p=0.159).
  • Normal/overweight patients (n=189) served as the reference group.

Conclusions:

  • Underweight status is a significant predictor of adverse 90-day postoperative outcomes in Crohn's disease patients.
  • Targeted preoperative nutritional optimization is recommended for underweight CD patients.
  • Further research may explore the nuances of obesity in CD surgical outcomes.
Abstract

Keywords:
Body mass indexCrohn's diseaseObesityPostoperative complicationsSurgeryUnderweight

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