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Impact of Metabolic Syndrome on the Morbidity and Mortality of Patients Undergoing Panniculectomy

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Abstract

Background

Metabolic syndrome (MetS) is defined as the concomitant disease process of obesity and at least two of the following variables: diabetes, hypertension, hypertriglyceridemia, or reduced high-density lipoprotein. These entities are well established as risk factors for complications following surgery. Obese patients are particularly prone to the development of MetS. The authors therefore aimed at elucidating the impact of MetS on the perioperative panniculectomy outcomes.

Methods

The American College of Surgeons National Surgical Quality Improvement Program database was analyzed for all primary procedures of panniculectomy from 2010 through 2015. The cases were stratified based on the presence or absence of MetS and evaluated for demographic data, intraoperative details, and their morbidity and mortality within 30 days after surgery.

Results

A total of 7030 cases were included in this study. Patients with MetS (6.2%) were of significantly worse health, required more emergency admissions (p = 0.022), longer hospitalization (p < 0.001), and more frequently inpatient procedures (p < 0.001) compared to the control group without MetS (3.8%). Plastic surgery was the predominant specialty operating on 79.5% of all cases. Surgical (23.3 vs. 8.7%) complications, readmission (8.7 vs. 3.0%), and reoperations (6.9 vs. 3.1%) rates were all significantly higher in patients with MetS that those without (p < 0.001). One fatality occurred in each cohort (0.23 vs. 0.02%, p = 0.010).

Conclusion

Comorbidities are not uncommon in patients undergoing panniculectomy, especially in those diagnosed with MetS. Health-care providers need to be aware of the increased morbidity and mortality in this high-risk subgroup and need to consider preoperative optimization and management before proceeding with surgery.

Level of Evidence III

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Acknowledgment

American College of Surgeons National Surgical Quality Improvement Program and the hospitals participating in the ACS NSQIP are the source of the data used herein; they have not verified and are not responsible for the statistical validity of the data analysis or the conclusions derived by the authors.

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Authors and Affiliations

  1. Institute for Reconstructive Surgery, Houston Methodist Hospital, Weill Cornell Medicine, 6560 Fannin Street, Scurlock Tower, Suite 2200, Houston, TX, 77030, USA

    Dmitry Zavlin, Christopher L. Balinger, Tue A. Dinh, Jeffrey D. Friedman & Anthony Echo

  2. Department of Plastic Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA

    Kevin T. Jubbal

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  1. Dmitry Zavlin
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  2. Kevin T. Jubbal
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Correspondence to Dmitry Zavlin.

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Conflict of interest

None of the authors, nor their close family members, have a financial interest in any of the products, devices, or drugs mentioned in this manuscript. Furthermore, the authors declare that no commercial associations or financial disclosures exist that might pose or create a conflict of interest with information presented in this manuscript. No funding was received for the work presented in this manuscript.

Ethical Approval

The work described in this manuscript was approved by the Houston Methodist Hospital’s institutional review board (IRB, protocol number Pro00011704). The authors adhered to the Declaration of Helsinki at all times. No informed consent was obtained as the patient data from the American College of Surgeons National Surgical Quality Improvement Program are only available in a de-identified format.

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Zavlin, D., Jubbal, K.T., Balinger, C.L. et al. Impact of Metabolic Syndrome on the Morbidity and Mortality of Patients Undergoing Panniculectomy. Aesth Plast Surg 41, 1400–1407 (2017). https://doi.org/10.1007/s00266-017-0952-6

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  • DOI: https://doi.org/10.1007/s00266-017-0952-6

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