The impact of obesity and morbid obesity on urgent/emergency colorectal resections: a regional database analysis

Autor: Ali Abunayla, Dennis Choi, Robert K. Cleary, Melissa I Chang, Samantha Hendren, Michael A Battaglia
Rok vydání: 2021
Předmět:
Zdroj: Surgical Endoscopy. 36:1876-1886
ISSN: 1432-2218
0930-2794
DOI: 10.1007/s00464-021-08467-1
Popis: The obesity rate is projected to reach 50% by 2030. Obesity may be modifiable prior to elective colorectal surgery, but there is no opportunity for weight loss when patients present for urgent/emergency operations. The impact of obesity focused on urgent/emergent colorectal operations has not been fully characterized. The study aim was to determine outcomes of obese patients who undergo urgent/emergency colorectal surgery and differences when compared with elective outcomes. This is a retrospective cohort study of 30-day outcomes for normal (BMI 18.5–25), obese (BMI 30–39.9), and morbidly obese (BMI > 40) patients in the Michigan Surgical Quality Collaborative between 1/1/2009 and 12/31/2018. Propensity score weighting was used to derive adjusted rates for overall morbidity, mortality, and specific complications. Primary outcome was postoperative complications (any morbidity). The study included 5268 urgent/emergency and 10,414 elective colorectal surgery patients. Postoperative complications were significantly more common in morbidly obese and obese than the normal BMI group for both urgent/emergency (morbidly obese 42.76% vs 33.75%, p = 0.003; obese 36.46% vs 33.75%, p = 0.043) and elective (morbidly obese 18.17% vs 13.36%, p = 0.004; obese 15.45% vs 13.36%, p = 0.011) operations. Surgical site infections are were significantly more common in morbidly obese and obese BMI groups as compared to normal BMI for both urgent/emergency and elective cases. Mortality was significantly higher in the morbidly obese (14.93% vs 11.44%, p = 0.013) but not obese BMI groups as compared to the normal BMI group for urgent/emergency cases. Mortality for all groups undergoing elective operations was
Databáze: OpenAIRE
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