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Journal of Gastrointestinal Surgery

, Volume 22, Issue 12, pp 2029–2036 | Cite as

The Association of Body Mass Index with Postoperative Outcomes After Elective Paraesophageal Hernia Repair

  • Samuel Torres Landa
  • Jordana B. Cohen
  • Robert A. Swendiman
  • Chris Wirtalla
  • Daniel T. Dempsey
  • Kristoffel R. Dumon
Original Article
  • 180 Downloads

Abstract

Purpose

To evaluate the association between body mass index (BMI) and postoperative outcomes in elective paraesophageal hernia (PEH) repairs.

Methods

A retrospective review of patients who underwent elective PEH repair in the ACS NSQIP database (2005–2015) was performed. Patients were stratified into BMI groups (< 18.5, 18.5–24.9, 25.0–29.9, 30.0–34.9, 35–39.9, and ≥ 40.0 kg/m2) according to the World Health Organization classification criteria. A multivariable logistic regression model was developed to characterize the association between BMI class and outcomes, including readmission, reoperation, postoperative complications, and mortality.

Results

The median (IQR) age of the 9641 patients who met inclusion criteria was 64 (55–72) and 72.7% were women. Across each BMI class, age, race, gender, type of procedure, frailty index, smoking, and ASA class varied (p < 0.05). Underweight patients (BMI < 18.5 kg/m2) had an increased risk of mortality (OR = 6.35, p < 0.05). Patients with a BMI 35–39.9 kg/m2 (OR = 0.65, p < 0.05) and ≥ 40 kg/m2 (OR = 0.36, p < 0.001) were associated with a decreased risk for readmissions.

Conclusion

Underweight patients have an increased risk for postoperative mortality after elective PEH repair. Higher BMI was associated with a diminished risk for readmission, but not for mortality, reoperations, or overall complications.

Keywords

Paraesophageal hernia NSQIP Obesity Outcomes Body mass index Underweight 

Notes

Acknowledgments

We thank Joseph Giacolone, Dr. Robert Caskey, Dr. Ari D. Brooks, Dr. Octavia E. Pickett-Blakely, Dr. Noel N. Williams, MD, and Dr. Andrew Sinnamon for providing with insightful input to the study.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2018

Authors and Affiliations

  • Samuel Torres Landa
    • 1
  • Jordana B. Cohen
    • 2
    • 3
  • Robert A. Swendiman
    • 1
  • Chris Wirtalla
    • 1
  • Daniel T. Dempsey
    • 1
  • Kristoffel R. Dumon
    • 1
  1. 1.Department of Surgery, Division of Gastrointestinal SurgeryPerelman School of Medicine, University of PennsylvaniaPhiladelphiaUSA
  2. 2.Department of Medicine, Renal-Electrolyte and Hypertension Division, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  3. 3.Center for Clinical Epidemiology and Biostatistics, Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA

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