Influence of obesity on in-hospital and postoperative outcomes of hepatic resection for malignancy: a 10-year retrospective analysis from the US National Inpatient Sample

Autor: Jiafa He, Yubin Liu, Taiying Chen, Shangzhou Xia, Xiangling Wei, Li Deng, Heping Liu
Rok vydání: 2019
Předmět:
Male
Databases
Factual
Hepatic resection
Psychological intervention
lcsh:Medicine
open liver resection
hepatocellular carcinoma (HCC)
0302 clinical medicine
Postoperative Complications
Hospital Costs
Aged
80 and over
national inpatient sample
Confounding
Liver Neoplasms
General Medicine
laparoscopic liver resection
Middle Aged
Tumor Burden
Treatment Outcome
Oncology
030220 oncology & carcinogenesis
030211 gastroenterology & hepatology
Female
Adult
medicine.medical_specialty
Carcinoma
Hepatocellular
Adolescent
Malignancy
03 medical and health sciences
Young Adult
medicine
Hepatectomy
Humans
Obesity
Aged
Retrospective Studies
Inpatients
Open liver resection
Inpatient care
obese
business.industry
Research
lcsh:R
Length of Stay
medicine.disease
United States
Surgery
Observational study
Laparoscopy
business
Zdroj: BMJ Open
BMJ Open, Vol 9, Iss 8 (2019)
ISSN: 2044-6055
Popis: ObjectivesThe influence of obesity on the outcomes of curative liver resection for malignancies remains controversial. We aimed to compare the in-hospital outcomes of liver resection for malignancy between obese and non-obese patients.DesignThis was a population-based, retrospective, observational study using data from the Nationwide Inpatient Sample (NIS), the largest all-payer US inpatient care database.SettingHospitalisations of adults ≥18 years old with diagnoses of primary hepatobiliary malignancy or secondary malignant neoplasms of liver in the USA were identified from the NIS database between 2005 and 2014.ParticipantsData of 18 398 patients ≥18 years old and underwent liver resection without pancreatic resection in the NIS were extracted. All included subjects had primary hepatobiliary malignancy or secondary malignant neoplasms of the liver. Patients were divided into obese and non-obese groups. These groups were compared with respect to postoperative complications, length of hospital stay and hospital cost according to surgical extent and approach.InterventionsPatients were undergoing lobectomy of liver or partial hepatectomy.Primary and secondary outcome measuresThe primary endpoints of this study were postoperative complications, length of hospital stay and hospital cost.ResultsAfter adjustment, obese patients were significantly more likely to experience postoperative complications than were non-obese patients (adjusted OR 1.25, 95% CI 1.10 to 1.42), regardless of whether lobectomy or partial hepatectomy was performed. Furthermore, obesity was significantly associated with increased risk of postoperative complications in patients who underwent open liver resection, but not laparoscopic resection. No significant difference was observed in length of hospital stay or total hospital costs between obese and non-obese patients.ConclusionsAfter adjustment for preoperative comorbidities and other potential confounders, obesity is significantly associated with greater risk of complications in patients undergoing open liver resection for malignancy, but not laparoscopic resection.
Databáze: OpenAIRE
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