Impact of obesity on the risk of wound infection following surgery: results from a nationwide prospective multicentre cohort study in England

Abstract

We sought to assess the impact of body mass index on the risk of surgical site infection in a prospective cohort study of 206 National Health Service (NHS) hospitals in England between 2007 and 2011. Body mass index was available for 159,720 of 350,089 operations among patients undergoing abdominal hysterectomy, coronary artery bypass graft, hip replacement, knee replacement, or large-bowel surgery. Among these patients, the risk of surgical site infection ranged from 0.65% for knee replacement to 11.04% for large-bowel surgery. Overall, 127,512 (79.8%) patients were overweight or obese (body mass index of ≥25 kg/m(2)). Obesity was associated with a 1.1-fold to 4.4-fold increase in the adjusted odds of developing surgical site infection as compared with normal weight, depending on the type of surgery. The population-attributable fraction (PAF) for body mass index was greatest in overweight (body mass index of 25.0-29.9 kg/m(2)) patients undergoing coronary artery bypass graft, accounting for 15% of their overall risk of surgical site infection (PAF 0.15; 95% CI 0.09-0.22). Being overweight or obese substantially increased the likelihood of patients developing surgical site infection. Given the increasingly high proportion of the surgical population who are overweight, this is likely to place a considerable additional burden on the NHS. Strategies for mitigating this excess risk need to be found.

Radiographic and functional outcomes after displaced intra-articular calcaneal fractures: a comparative cohort study among the traditional open technique (ORIF) and percutaneous surgical procedures (PS)

“…This percentage is similar to that reported by different authors: 24 % De Groot et al [38], 24 % Koski et al [20], and 16 % De Boer et al [41]. Although some studies have shown a correlation between complication and obesity [35, 42, 43], diabetes, absence of drainage, and complicated fractures [21], in our series, only Sanders III fractures showed a higher risk (odds ratio (OR) = 4.51).…”

Obesity Education Strategies for Cancer Prevention in Women’s Health

“…For these patients, water-based aerobic activity may be a helpful suggestion. Total knee or hip arthroplasty may be an appropriate option, but extreme obesity is associated with significantly increased risk of surgical site infections [57]. With increasing scrutiny from hospitals and insurance companies on postoperative morbidity, orthopedists may be increasingly deterred from performing total knee arthroplasty in morbidly obese patients.…”

Addressing the challenges of sleeve gastrectomy in end-stage renal disease: Analysis of 100 consecutive renal failure patients

“…11,12 Second, ESRD-related platelet dysfunction may result in impaired hemostasis intraoperatively. 13 Third, DM is often severe within this population and requires meticulous medical management.…”