Mortality in open abdominal aortic surgery in patients with morbid obesity
| Autor: | C. Anthony Howard, Peter J. Lau, Guido M. Sclabas, Kevin E. Taubman, Rafael D. Malgor, Zhamak Khorgami, Ali Aminian, Geoffrey S. Chow |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis 030209 endocrinology & metabolism Comorbidity Morbid obesity 03 medical and health sciences 0302 clinical medicine Postoperative Complications Weight loss Risk Factors medicine Humans In patient Aorta Abdominal Risk factor Elective surgery Aged Retrospective Studies business.industry Odds ratio Middle Aged medicine.disease Abdominal aortic aneurysm Surgery Obesity Morbid 030211 gastroenterology & hepatology Female medicine.symptom business Vascular Surgical Procedures Aortic Aneurysm Abdominal |
| Zdroj: | Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 15(6) |
| ISSN: | 1878-7533 |
| Popis: | Background Open abdominal aortic surgery is among procedures with high morbidity and mortality. Adverse postoperative complications may be more common in morbidly obese patients. Objectives This study compared the outcomes of open abdominal aortic surgeries in patients with and without morbid obesity. Setting A retrospective analysis of 2007–2014 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample. Methods We included patients who underwent open abdominal aortic aneurysm (AAA) repair or open aorta-iliac-femoral (AIF) bypass. Demographic factors, morbid obesity, co-morbidities, and emergent versus elective surgery were considered for univariate and multivariate analyses. Results A total of 29,340 patients (13,443 AAA repair and 15,897 AIF bypass) were included (age 66.3 ± 10.8 years, 65.7% male). The mortality was 9.1% in 536 patients with morbid obesity compared with 7.1% in patients without morbid obesity. Based on multivariate analysis, age, existing co-morbidities, emergent versus elective setting, and morbid obesity were found to be independent predictors of mortality. Patients with morbid obesity had an odds ratio of 3.61 (95% CI, 1.50–8.68; P = .004) for mortality, longer mean length of stay (11.2 versus 9.3 days, P Conclusions Morbid obesity is an independent risk factor of mortality in patients undergoing open AAA repair and AIF bypass. Weight loss strategies should be considered for morbidly obese patients with an anticipation of open abdominal aortic procedures. |
| Databáze: | OpenAIRE |
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