Association between overweight/obesity and postoperative complications at the San Francisco General Hospital of the Ecuadorian Institute of Social Security.
DOI:
https://doi.org/10.29166/rfcmq.v46i1.2695Keywords:
Obesity, Overweight , Body Mass Index, Postoperative complications, Surgical wound infectionAbstract
Introduction: Overweight/obesity are a pandemic, which leads to an increase in the probability of suffering from metabolic syndrome, type 2 diabetes mellitus and cardiovascular disease. The current literature is controversial between the association of overweight or obesity with post-surgical complications.
Objective: To evaluate the association between overweight/obesity and postoperative complications in a general hospital in Quito-Ecuador in 2019.
Methods: The sample consisted of individuals with surgical intervention in October 2019. Those who presented underweight (BMI<18.5 kg/m2) were excluded. The independent variable was overweight/obesity versus normal weight (BMI≥25 kg/m2, vs <18.5 kg/m2, respectively); the dependent one was the presence of postsurgical complications, using the Clavien-Dindo classification, dichotomizing the absence (0, I, II) and the presence (IIIa, IIIb, IVa, IVb, V) of complications. A bivariate analysis was performed using chi square test (p<0.05) and unadjusted and adjusted logistic regression models to obtain “Odds Ratio” and 95% confidence intervals.
Results: Overweight or obesity did not show a statistically significant association with the presence of complications (OR: 3.23; CI 95%: 0.42-24.83). Of 120 participants, 50.8% were male. The mean BMI was 27.54 ± 4.97 kg/m2. The postoperative complication rate was 8.33%, of which 50% were overweight or obese. The predominant approach was laparoscopy.
Conclusions: No association was found between overweight/obesity and postoperative complications. However, a high prevalence of overweight and obesity was evidenced. It is recommended to carry out future longitudinal studies and these with a larger population to contrast results.
Downloads
Metrics
References
OMS. Obesidad y sobrepeso [Internet]. 2020 [cited 2020 Jun 22]. Available from: https://www.who.int/es/news-room/fact-sheets/detail/obesity-and-overweight
Fruh SM. Obesity: Risk factors, complications, and strategies for sustainable long-term weight management. J Am Assoc Nurse Pract. 2017;29:S3–14.
Pérez-Galarza J, Baldeón L, Franco OH, Muka T, Drexhage HA, Voortman T, et al. Prevalence of overweight and metabolic syndrome, and associated sociodemographic factors among adult Ecuadorian populations: the ENSANUT-ECU study. J Endocrinol Invest. 2020.
Kadia BM, Chichom-Mefire A, Halle-Ekane GE. Exploring the role of obesity and overweight in predicting postoperative outcome of abdominal surgery in a sub-Saharan African setting: A prospective cohort study. BMC Res Notes. 2018;11(1):1–7.
Clavien PA, Sanabria JR SS. Proposed classification of complications of surgery with examples of utility in cholecystectomy. Surgery [Internet]. 1992;111(5):518–526. Available from: https://pubmed.ncbi.nlm.nih.gov/1598671/
Dindo D, Demartines N, Clavien P-A. Classification of Surgical Complications. Ann Surg [Internet]. 2004 Aug;240(2):205–13. Available from: http://journals.lww.com/00000658-200408000-00003
Mitropoulos D, Artibani W, Biyani CS, Bjerggaard Jensen J, Rouprêt M, Truss M. Validation of the Clavien–Dindo Grading System in Urology by the European Association of Urology Guidelines Ad Hoc Panel. Eur Urol Focus [Internet]. 2018 Jul;4(4):608–13. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2405456917300627
Meijs AP, Koek MBG, Vos MC, Geerlings SE, Vogely HC, De Greeff SC. The effect of body mass index on the risk of surgical site infection. Infect Control Hosp Epidemiol. 2019;40(9):991–6.
Bandeira Ferraz ÁA, Vasconcelos CF de M, Santa-Cruz F, Aquino MAR, Buenos-Aires VG, Siqueira LT de. Surgical site infection in bariatric surgery: Results of a care bundle. Rev Col Bras Cir. 2019;46(4):1–8.
Makino T, Shukla PJ, Rubino F, Milsom JW. The impact of obesity on perioperative outcomes after laparoscopic colorectal resection. Ann Surg. 2012;255(2):228–36.
Doyle SL, Lysaght J, Reynolds J V. Obesity and post-operative complications in patients undergoing non-bariatric surgery. Obes Rev. 2010;11(12):875–86.
Benjamin ER, Dilektasli E, Haltmeier T, Beale E, Inaba K, Demetriades D. The effects of body mass index on complications and mortality after emergency abdominal operations: The obesity paradox. Am J Surg. 2017;214(5):899–903.
García-García ML, Martín-Lorenzo JG, Lirón-Ruiz R, Torralba-Martínez JA, García-López JA, Aguayo-Albasini JL. Perioperative complications following bariatric surgery according to the clavien-dindo classification. Score validation, literature review and results in a single-centre series. Surg Obes Relat Dis [Internet]. 2017 Sep;13(9):1555–61. Available from: http://dx.doi.org/10.1016/j.soard.2017.04.018
Tjeertes EEKM, Hoeks SSE, Beks SSBJC, Valentijn TTM, Hoofwijk AAGM, Stolker RJRJ. Obesity - a risk factor for postoperative complications in general surgery? BMC Anesthesiol [Internet]. 2015;15(1):1–7. Available from: http://dx.doi.org/10.1186/s12871-015-0096-7
Antonopoulos AS, Tousoulis D. Themolecularmechanisms of obesity paradox. Cardiovasc Res. 2017;113(9):1074–86.
Blanco-Colino R, Lee S, Kamarajah SK, Vasko P, Kuiper SZ, Farina V, et al. Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis. Color Dis. 2018;20(8):O215–25.
Collaborative S. Multicentre prospective cohort study of body mass index and postoperative complications following gastrointestinal surgery. 2016 [cited 2020 Jul 8]; Available from: www.starsurg.org
Bolliger M, Kroehnert JA, Molineus F, Kandioler D, Schindl M, Riss P. Experiences with the standardized classification of surgical complications (Clavien-Dindo) in general surgery patients. Eur Surg - Acta Chir Austriaca. 2018;50(6):256–61.
Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. NIH Public Access Author Manuscript J Biomed Inform. Author manuscript; available in PMC 2010 April 1. Published in final edited form as: J Biomed Inform. 2009 April; 42(2): 377–381. doi:10.1016/j.jbi.2008.08.010. Research Electronic Data Capture (REDCap. J Biomed Inf. 2009;42(2):377–81.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Ronnal Patricio Vargas Cordova
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
