Metabolic Syndrome as a Predictor for Postoperative Complications After Urologic Surgery

Selph, J. Patrick; Whited, William M.; Smith, Angela; Matthews, Jonathan; Pruthi, Raj S.; Wallen, Eric; Nielsen, Matthew E.; Woods, Michael

doi:10.1016/j.urology.2014.01.014

Cited by 19 publications

(13 citation statements)

References 25 publications

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“…In our study, we found patients from the exposed cohort to developed more over all complications in the perioperative period, which also had higher weight and BMI. Other authors have also found the presence of MS to be a significant predictor of perioperative complications after radical nephrectomy (adjusted OR, 1.489; 95%CI, 1.146 -1.934), in 3337 patients for which complete data to analyze were available [38]. Mullen et al found that obesity alone may not always increase perioperative morbidity and mortality [39].…”

Section: Discussionmentioning

confidence: 99%

“…In Medellín, an urban population of Colombia, Davila et al reported in 2013 a prevalence of 40.7% for MS [38]. Currently, there is an increasingly high prevalence of patients with MS reported in national and international series where insulin resistance, defined as a state of reduced biological response to physiological concentrations of insulin [3], is a key component of the syndrome, and appears to be the result of excess abdominal adipose tissue; with increased secretion of free fatty acids (FFAs) and pro-inflammatory factors including alpha tumor necrosis factor (TNFa), IL-6 and other adipokines, all resulting in a defect in the transport of glucose to the level of skeletal muscle, and alterations in lipid metabolism [14] [19] [20].…”

Section: Introductionmentioning

confidence: 99%

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Metabolic Syndrome and Perioperative Complications during Scheduled Surgeries with Spinal Anesthesia

Pomares¹,

Mora-García²,

Palomino³

et al. 2014

OJAnes

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Background: Metabolic syndrome (MS) is a constellation of factors associated with increased risk of developing cardiovascular diseases and Diabetes Mellitus. Despite of the many studies related to MS, little is known about its impact on scenarios such as surgical anesthesia. Objective: To examine the correlation between demographic and metabolic variables with the occurrence of perioperative complications in patients with MS undergoing scheduled surgeries using a spinal anesthesia technique in the surgery department at the University Clinic San Juan de Dios in Cartagena de Indias, Colombia. Methods: Observational, analytical, cross-sectional, single-center study of 150 subjects with MS and 150 control subjects. Perioperative complications, socio-demographic, hemodynamic and respiratory variables were registered. Groups were compared using t test, Fisher's exact test or Chi-square, as appropriate. We applied a logistic multiple regression model, adjusted by backward stepwise at 0.25 and forward at 0.05, to find possible incompatible associations. p value < 0.05 was considered significant. Results: There were significant differences between groups in age, American Society of Anesthesiologists physical status classification, frequency of diseases associated to MS and perioperative complications. There were no cases of mortality among patients. There was statistically significant difference between the two groups for intraoperative hypotension and hypertension with p values of <0.0001 and 0.034. Among postoperative complications there was statistically significant difference in pain (13.3% vs 5.3% in patients without MS) and nausea and/or postoperative vomiting (8% vs 2% in patients without MS) with a * Corresponding author. J. Pomares et al. 168 p value of 0.027 and 0.015 (by Fisher) respectively. Conclusions: Metabolic abnormalities in MS are a risk factor for developing complications in the perioperative period of patients scheduled for surgeries using the subarachnoid anesthesia technique. Accordingly, it is appropriate to implement health intervention strategies by the surgical team, aiming at their prevention and management.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Metabolic Syndrome and Perioperative Complications during Scheduled Surgeries with Spinal Anesthesia

Pomares¹,

Mora-García²,

Palomino³

et al. 2014

OJAnes

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“…The subject of surgical complications after RP in MetS patients has been analyzed by very few studies. Using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database, Selph et al reported on 7496 patients who underwent RP between 2005 and 2011. Since dyslipidemia (D) was not captured in the NSQIP data set, MetS presence was assessed using an adapted and reduced version of the IDF diagnostic criteria (body mass index [BMI] > 30.0 kg/m 2 , hypertension [HTN] requiring medication, and diabetes [DM] requiring an oral agent or insulin therapy).…”

Section: Discussionmentioning

confidence: 99%

“…MetS has been associated with worse oncological outcomes after radical prostatectomy (RP) for pCa, even though definitive evidence regarding this issue is still lacking and these results have been questioned by other works . MetS was associated to an increased complication rate after many different surgical procedures; a recent study however did not find an increased risk of complications for MetS patients undergoing RP . From a biological standpoint, the complex metabolic alterations present in MetS could worsen the functional outcomes after RP.…”

Section: Introduction and Aimmentioning

confidence: 98%

“…3,4 MetS was associated to an increased complication rate after many different surgical procedures 5 ; a recent study however did not find an increased risk of complications for MetS patients undergoing RP. 6 From a biological standpoint, the complex metabolic alterations present in MetS could worsen the functional outcomes after RP. However, very little is known about the role of MetS on the recovery after RP for prostate cancer and its association with the risk of urinary incontinence, impotence, short-and long-term complications.…”

Section: Introduction and Aimmentioning

confidence: 99%

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Impact of metabolic syndrome on functional outcomes and complications of surgical treatment of prostate cancer

Morlacco

Moro

Rangel

et al. 2019

Journal of Surgical Oncology

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Background Metabolic syndrome (MetS) has a negative impact on functional recovery and complications after many surgical procedures. Aim To assess the role of Mets on functional outcomes and complications after radical prostatectomy (RP) for prostate cancer. Patients and Methods Complete data were collected from 5758 patients, undergoing RP at a single referral centers in a 10‐year period and the presence of MetS before surgery was ascertained in 17.7% of them using a modified version of the IDF‐AHA/NHLBI criteria. Outcomes included 1‐year continence and potency rates, early (≤90 days) and late (>90 days) complications. Results Postoperative continence (no pads) was significantly less likely in MetS patients (75.4% vs 82.6%, P < .01), despite no difference in preoperative continence. Erections with or without therapy were reached in 55.8% of non‐MetS and 41.8% of MetS patients (P < .01), in this case a significant difference in preoperative function was seen. No differences in early and late complications, except for wound infections (5.8% vs 3.9%, P < .01) were observed. Conclusions In the present study RP was safe from the complications standpoint in MetS patients, but the presence of the syndrome was a significant risk factor for post‐RP incontinence and impotence.

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The impact of preoperative nutritional status on post-surgical complication and mortality rates in patients undergoing radical cystectomy for bladder cancer: a systematic review of the literature

et al. 2020

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Metabolic Syndrome as a Predictor for Postoperative Complications After Urologic Surgery

Cited by 19 publications

References 25 publications

Metabolic Syndrome and Perioperative Complications during Scheduled Surgeries with Spinal Anesthesia

Metabolic Syndrome and Perioperative Complications during Scheduled Surgeries with Spinal Anesthesia

Impact of metabolic syndrome on functional outcomes and complications of surgical treatment of prostate cancer

The impact of preoperative nutritional status on post-surgical complication and mortality rates in patients undergoing radical cystectomy for bladder cancer: a systematic review of the literature

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