6533b835fe1ef96bd129ed3f

RESEARCH PRODUCT

Body mass index and complications following major gastrointestinal surgery

Blanco-colino RLee SKamarajah SkVasko PKuiper SzFarina VChapman SjDrake TmGavagna LPasquali SPata FPellino GDe La Rosa-estadella MStellingwerf MeStijns RchBorrellas AGolding DNgaage MVan Tol RrDe Groof JDe Wilt HBemelman WaMcnamee LEspin-basany EEmre Baki BGecim IeCan Tatar OBach SBhangu ABresges KBurke JClaireaux HaFearnhead NFitzgerald JeGallagher SGlasbey JcGundogan BHarrison EmHernon JKhatri CKong CyLyons AMohan MMorton DPinkney TdArezzo AFoppa CMorino MRubbini MSelvaggi FSensi BSica GOrhalmi JNaccari PSgrò ABurger BhcmFares DaSpijkerman RVan Elst TrWiersema RStassen LpsRodriguez Garcia RÖZkan BbTavuz AiDemirci ZsBaki BeChoi PjO'sullivan HSalman MSimioni AColombo FTurati LCazzola FeGallo GPerrotta GPapandrea MNaccari PmMenduni NRossi EChetta NRomeo FGiordano FRandisi BCurletti GKuiper JCosta AMarcos Rodrigo ASanchez AVaro Muñoz AMartinez Rios CeAliseda-jover DFernandez Nieto DAlvarez Reyes IDominguez Rodriguez LmHernandez Ros MiEsteban Sinovas OBartrina Soler PVillarejo Campos 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MaleobesityMultivariate analysisGastrointestinal DiseasesIMPACTSettore MED/18 - CHIRURGIA GENERALEBody mass index; Body weight; Digestive tract; Gastrointestinal tract; Obesity; Postoperative complications; Gastroenterologydigestive tractTumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14]0302 clinical medicineGastrointestinal tractRisk FactorsMedicineProspective StudiesProspective cohort studyBody mass indexBody mass index; Body weight; Digestive tract; Gastrointestinal tract; Obesity; Postoperative complications; Aged; Europe; Female; Gastrointestinal Diseases; Gastrointestinal Neoplasms; Humans; Male; Middle Aged; Obesity; Postoperative Complications; Prospective Studies; Risk Factors; Body Mass IndexGastrointestinal NeoplasmsOUTCOMESPostoperative complications; body mass index; body weight; digestive tract; gastrointestinal tract; obesityGastroenterologyMiddle AgedBody mass index; Body weight; Digestive tract; Gastrointestinal tract; Obesity; Postoperative complicationsEurope030220 oncology & carcinogenesisMeta-analysisUrological cancers Radboud Institute for Health Sciences [Radboudumc 15]CohortFemale030211 gastroenterology & hepatologyCohort studymedicine.medical_specialtybody mass indexMalignancyNO03 medical and health sciencesPostoperative complicationsbody weightSDG 3 - Good Health and Well-beingHumansDigestive tractObesityAgedbusiness.industrypostoperative complications; obesity; digestive tract; gastrointestinal tract; body mass index; body weightMORTALITYBody weightmedicine.diseaseObesitySettore MED/18SurgeryPostoperative complicationPostoperative Complications Obesity Digestive Tract Gastrointestinal Tract Body Mass Index Body Weight.gastrointestinal tractbusinessBody mass index

description

Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a meta-analysis of all available prospective data.Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien-Dindo Grades III-V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results.Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery for malignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49-2.96, P <0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46-0.75, P <0.001) compared to normal weight patients.Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease.

10.1111/codi.14292https://doi.org/10.1111/codi.14292