Effect of Body Mass Index on Perioperative Complications in Thoracic Surgery

Suemitsu, Ryuichi; Sakoguchi, Taro; Morikawa, Keiko; Yamaguchi, Masafumi; Tanaka, Hiroyuki; Takeo, Sadanori

doi:10.1177/021849230801600607

Cited by 21 publications

(13 citation statements)

References 9 publications

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“…Diffi culty with intubation occasionally occurs with obese or extremely obese patients; however, normal-weight and underweight patients seemed to have fewer intraoperative problems than obese patients. 16,17 There was no statistical difference in postoperative cardiac complications among the four groups; however, thoracic complications clearly increased with a decreasing BMI. In particular, postoperative pneumonia was statistically higher in extremely underweight patients.…”

Section: Discussionmentioning

confidence: 82%

The results of surgery under general anesthesia in patients with lung cancer

et al. 2010

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Section: Discussionmentioning

confidence: 82%

The results of surgery under general anesthesia in patients with lung cancer

et al. 2010

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“…In a retrospective review of 499 patients who underwent resections for non-small cell lung cancer (NSCLC), a higher BMI was not associated with increased incidence of perioperative complications, mortality or length of stay (18). In contrast two retrospective studies have shown no effect on mortality but higher incidence of intra-thoracic complications (19, 20). …”

Section: Introductionmentioning

confidence: 81%

Morbidities of lung cancer surgery in obese patients

Dhakal

Eastwood

Sukumaran

et al. 2013

The Journal of Thoracic and Cardiovascular Surgery

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Background Obesity is a risk factor for increased peri-operative morbidity and mortality in surgical patients. There have been limited studies to correlate the morbidity of lung cancer resection with obesity. Methods We performed a retrospective study of patients who underwent surgical resection for lung cancer at the Medical College of Wisconsin from 2006 to 2010. Data on patient demographics, weight, pathology findings and hospital course were abstracted after appropriate IRB approval. Peri-operative morbidity was defined as atrial fibrillation, heart failure, respiratory failure, pulmonary embolism or any medical complications arising within 30 days after surgery. Fisher’s exact test was used to test the association between BMI and peri-operative morbidities. Results Between 2006 and 2010,320 lung resections were performed for lung cancer. Median age was 67(IQR 59–75) years and 185(57.8%) were females.121 (37.8%) patients had a BMI<25 and 199(62.18%) patients had a BMI≥25. The 30-day mortality rate was 1.8 % (n=6) in the whole group; only 2 of these patients had a BMI ≥ 25. Peri-operative morbidity occurred in 28(23.14%) of normal BMI patients and in 47(23.61%) of BMI ≥ 25 patients (p=0.54). Specific morbidities encountered by patients with normal vs. BMI ≥ 25 were: atrial fibrillation 11(9.09%) vs. 24(12.06%) (p=0.46), Pulmonary embolism 1(0.83%) vs. 3(1.51%) (p=1.0), congestive heart failure 2(1.65%) vs. 2(1.01%) (p=0.63), renal failure 4(3.3%) vs.2 (1.0%)(p=0.29), respiratory failure 12(9.92%) vs. 17(8.54%) (p=0.69) and acute respiratory distress syndrome 2(1.65%) vs. 1(0.50%) (p=0.55). Median hospital stay was 5 days in the lower BMI group and 4 days in the BMI ≥25 groups (p=0.52). Conclusions Overweight and normal weight patients do not differ significantly in rates of perioperative morbidities, 30-day mortality and length of stay. Our study indicates that potential curative surgical resections can be offered to even significantly overweight patients.

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“…Moreover, prior studies of lung resection suggested that overweight and obesity had favorable surgical outcomes, whereas underweight adversely affected perioperative morbidity and operative mortality [ 7 , 12 ]. Conversely, in other studies of lung cancer, patients with elevated BMI had increased risk of intrathoracic [ 5 ] and respiratory complications [ 6 ]. Launer et al described on patients with lung cancer who underwent lobectomy, indicating that obesity was associated with increased risk of postoperative pulmonary complications, but not mortality or other morbidities after lobectomy [ 13 ].…”

Section: Introductionmentioning

confidence: 90%

“…Recently, attention has been focused on the factors influencing perioperative outcomes. One factor shown to predict outcomes in lung cancer is body mass index (BMI) [ 5 – 8 ]. However, to date, the data regarding the influence of elevated BMI on surgical outcomes have been mixed.…”

Section: Introductionmentioning

confidence: 99%

Association of body mass index and outcomes following lobectomy for non-small-cell lung cancer

et al. 2018

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BackgroundObesity and overweight have become increasingly prevalent, but no consensus has been reached regarding the effect of body mass index (BMI) on surgical outcomes. In this study, we sought to examine the influence of BMI on perioperative outcomes in a large cohort of patients with non-small-cell lung cancer (NSCLC) who underwent lobectomy.MethodsA retrospective study was conducted in 1198 patients who underwent lobectomy for primary NSCLC at Shandong Provincial Hospital between November 2006 and January 2017. BMI was calculated using measured height and weight on admission and categorized as obese (≥ 30 kg/m2), overweight (25 to 29.9 kg/m2), normal (18.5 to 24.9 kg/m2), or underweight (< 18.5 kg/m2). Patients’ baseline characteristics and outcomes were abstracted from medical records following institutional review board approval. Endpoints included operative mortality, perioperative complications, and length of stay (LOS). Complications were divided into four groups as respiratory, cardiovascular, other, and overall. Logistic regression models were constructed to assess the association between BMI and adverse outcomes.ResultsWhen compared with normal BMI, obesity and overweight did not increase the risk of complications in any category, operative mortality, or prolonged LOS. In fact, the incidence of operative mortality and respiratory complications tended to be lower in overweight patients than in normal weight patients (P = 0.047 and P = 0.041, respectively). Conversely, underweight patients experienced significantly more operative mortality, respiratory complications, and prolonged LOS (P = 0.004, P = 0.011, and P = 0.003, respectively).ConclusionsObesity and overweight did not confer adverse surgical outcomes. Underweight patients presented increased risk of respiratory complications, perioperative death, and prolonged LOS. Thus, overweight and obesity should not be a relative contraindication for lobectomy. Meanwhile, nurses and surgeons should focus on perioperative management of underweight patients.

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Effect of Body Mass Index on Perioperative Complications in Thoracic Surgery

Cited by 21 publications

References 9 publications

The results of surgery under general anesthesia in patients with lung cancer

The results of surgery under general anesthesia in patients with lung cancer

Morbidities of lung cancer surgery in obese patients

Association of body mass index and outcomes following lobectomy for non-small-cell lung cancer

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