Abstract
Background
Postoperative complications are undesirable and potentially common in the increasing obese population of surgical patients. There is a scarcity of recent and reliable studies comparing postoperative morbidity and mortality in obese and nonobese patients. The aim of this study was to evaluate the prevalence, pattern, and severity of postoperative complications in obese and nonobese surgical patients.
Methods
A retrospective review and analysis of adult postoperative complications recorded on an electronic database was conducted. The database covered a period of 4 years and consisted of 7,271 cases of postoperative complications that occurred within 30 days of noncardiac moderate or major surgery. Appropriate data and variables were compared between obese and nonobese patients using the SPSS program.
Results
The rate of postoperative complications was 7.7%. Obese patients had a higher prevalence of myocardial infarction (P = 0.001), peripheral nerve injury (P = 0.039), wound infection (P = 0.001), and urinary tract infection (P = 0.004). ). Morbidly obese patients had a higher mortality rate of 2.2% compared with 1.2%; for all other patients (P = 0.034) and a higher prevalence of tracheal reintubation (P = 0.009) and cardiac arrest (P = 0.015). Obese patients had higher American Society of Anesthesiologists (ASA) physical status scores than other patients (P = 0.001).
Conclusions
Obese patients have a significantly higher risk of postoperative myocardial infarction, wound infection, nerve injury, and urinary infection. Obesity is an independent risk factor for perioperative morbidity, and morbid obesity is a risk factor for mortality.
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References
Mangano DT. Perioperative medicine: NHLBI working group deliberations and recommendations. J Cardiothorac Vasc Anesth 2004;18:1–6
Adams JP, Murphy PG. Obesity in anaesthesia and intensive care. Br J Anaesth 2000;85:91–108
Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA 2004;291:1238–1245
Office of the Surgeon-General. The Surgeon-General’s call to action to prevent and decrease overweight and obesity. Public Health Service, Rockville, US Department of Health and Human Services. Office of the Surgeon-General, 2001
Centers for Disease Control & Prevention. Overweight and obesity. Atlanta, US Department of Health and Human Services, Centers for Disease Control & Prevention, 2005
Dominguez-Cherit G, Gonzalez R, Borunda D, et al. Anesthesia for morbidly obese patients. World J Surg 1998;22:969–973
Fleischmann E, Kurz A, Niedermayr M, et al. Tissue oxygenation in obese and non-obese patients during laparoscopy. Obes Surg 2005;15:813–819
Eichenberger AS, Proietti S, Wicky S, et al. Morbid obesity and postoperative pulmonary atelectasis: an underestimated problem. Anesth Analg 2002;95:1788–1792
Agarwal N, Shibutani K, SanFilippo JA, Del-Guercio LR. Hemodynamic and respiratory changes in surgery of the morbidly obese. Surgery 1982;92:226–234
Postlethwait RW, Johnson WD. Complications following surgery for duodenal ulcer in obese patients. Arch Surg 1972;105:438–440
Dindo D, Muller MK, Weber M, Clavien P-A. Obesity in general elective surgery. Lancet 2003;361:2032–2035
Klasen J, Junger A, Hartmann B, et al. Increased body mass index and perioperative risk in patients undergoing non-cardiac surgery. Obes Surg 2004;14:275–281
Nathan B. A medieval medical view on obesity. Obes Surg 1992;2:217
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Bamgbade, O.A., Rutter, T.W., Nafiu, O.O. et al. Postoperative Complications in Obese and Nonobese Patients. World J. Surg. 31, 556–560 (2007). https://doi.org/10.1007/s00268-006-0305-0
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DOI: https://doi.org/10.1007/s00268-006-0305-0