Details

Autor(en) / Beteiligte

• Choi, Dennis
• Hendren, Samantha
• Chang, Melissa I.
• Abunayla, Ali
• Battaglia, Michael A.
• Cleary, Robert K.

Titel

The impact of obesity and morbid obesity on urgent/emergency colorectal resections: a regional database analysis

Ist Teil von

• Surgical endoscopy, 2022-03, Vol.36 (3), p.1876-1886

Ort / Verlag

New York: Springer US

Erscheinungsjahr

2022

Quelle

MEDLINE

Beschreibungen/Notizen

• Background The obesity rate is projected to reach 50% by 2030. Obesity may be modifiable prior to elective colorectal surgery, but there is no opportunity for weight loss when patients present for urgent/emergency operations. The impact of obesity focused on urgent/emergent colorectal operations has not been fully characterized. The study aim was to determine outcomes of obese patients who undergo urgent/emergency colorectal surgery and differences when compared with elective outcomes. Methods This is a retrospective cohort study of 30-day outcomes for normal (BMI 18.5–25), obese (BMI 30–39.9), and morbidly obese (BMI > 40) patients in the Michigan Surgical Quality Collaborative between 1/1/2009 and 12/31/2018. Propensity score weighting was used to derive adjusted rates for overall morbidity, mortality, and specific complications. Primary outcome was postoperative complications (any morbidity). Results The study included 5268 urgent/emergency and 10,414 elective colorectal surgery patients. Postoperative complications were significantly more common in morbidly obese and obese than the normal BMI group for both urgent/emergency (morbidly obese 42.76% vs 33.75%, p  = 0.003; obese 36.46% vs 33.75%, p  = 0.043) and elective (morbidly obese 18.17% vs 13.36%, p  = 0.004; obese 15.45% vs 13.36%, p  = 0.011) operations. Surgical site infections are were significantly more common in morbidly obese and obese BMI groups as compared to normal BMI for both urgent/emergency and elective cases. Mortality was significantly higher in the morbidly obese (14.93% vs 11.44%, p  = 0.013) but not obese BMI groups as compared to the normal BMI group for urgent/emergency cases. Mortality for all groups undergoing elective operations was < 1% and with no significant differences. Conclusions Morbid obesity and obesity are associated with complications that are largely driven by surgical site infections after both urgent/emergency and elective colorectal surgery. Obesity is a risk factor difficult to modify prior to urgent/emergency surgery. Managing complications related to obesity after colorectal surgery will be a continued challenge with projected increasing obesity rates.