Seasonality in the adverse outcomes in weight loss surgeries

Hu, Qingwei; Shi, Lu; Chen, Liwei; Zhang, Lu; Truong, Khoa; Ewing, Alex; Wu, Jiande; Scott, John D.

doi:10.1016/j.soard.2017.11.029

Cited by 8 publications

(5 citation statements)

References 40 publications

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“…The in uence of operative season on patient outcomes has recent attracted research interest. Several studies have demonstrated that patients undergoing surgery during the winter have increased morbidity and mortality [5,6,8,27]. It has been hypothesized that weather conditions could follow a seasonal pattern in uenced by temperature, sun exposure or viral infections; however, we found no seasonal pattern in CRC surgery outcomes, as the clusters of months followed a non-consecutive distribution.…”

Section: Discussioncontrasting

confidence: 65%

“…Likewise, a cyclical pattern has been suggested for shortterm outcomes of surgery [24][25][26]. It has been reported that postoperative complications in pancreatic or bariatric surgery may present variable incidence, with peak periods of worse outcomes that could show a monthly cyclical pattern [27,28]. However, these ndings have not been reported for CRC surgery [14].…”

Section: Discussionmentioning

confidence: 99%

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Seasonal or cyclical pattern in short-term postoperative outcomes of colorectal cancer? A time series analysis.

Martín-Arévalo,

Moro-Valdezate,

García-Botello

et al. 2024

Preprint

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Purpose To identify a cyclical pattern in short-term postoperative outcomes after colorectal cancer (CRC) surgery across the year. Methods Observational study including all consecutive patients diagnosed with CRC who underwent oncological surgery between January 2012 and December 2023. A time series study was performed to identify a possible cyclic pattern of postoperative complications. Non-supervised learning techniques were used to identify months of surgery with similar outcome variables in the time series. Multivariable analysis with logistic binary regression was conducted to identify independent risk factors for postoperative complications. Results A total of 1576 patients met the inclusion criteria. The postoperative morbidity and mortality rates were 41.1% and 3.7%, respectively. A cyclical pattern was identified, suggesting that postoperative complications were periodically higher in some months across the year. Three different clusters were identified. Group 1: January, April, July, and August; Group 2: February, May, September, November, and December; and Group 3: March, June, and October. No differences in baseline characteristics were found between clusters. Group 3 presented the highest rate of anastomotic leak (p ≤ 0.001;OR = 1.61, 95%CI = 1.30–2.00), unnoticed perforation p = 0.027;OR = 1.86, 95%CI = 1.18–2.93), diffuse postoperative peritonitis (p = 0.018;OR = 1.50, 95%CI = 1.10–2.04) and needed more postoperative reoperations (p = 0.013;OR = 1.33, 95%CI = 1.07–1.65). Multivariate analysis revealed male sex (p = 0.002), duration of operation (p = 0.017) and month grouping (p ≤ 0.001) as independent risk factors for anastomotic leak. Conclusion Postoperative complications after CRC surgery follow a cyclical pattern, but without seasonal distribution. Three well-defined clusters with different postoperative outcomes have been identified. Month cluster was one of the independent risk factors for anastomotic leak.

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Section: Discussioncontrasting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Seasonal or cyclical pattern in short-term postoperative outcomes of colorectal cancer? A time series analysis.

Martín-Arévalo,

Moro-Valdezate,

García-Botello

et al. 2024

Preprint

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“…Although the surgeries in that study were different, they were all thoracic surgeries, and the results were similar to our study. A study on postoperative complications of bariatric surgery in the United States reported that although adverse events, such as deep vein thrombosis and sepsis, were rare, they were more likely to occur in the cold season than in summer (15). We found no significant seasonal difference in these complications.…”

Section: Discussioncontrasting

confidence: 57%

Relationship between postoperative complications of esophageal cancer surgery and season: a retrospective study

Liu¹,

Gao²,

Xing³

et al. 2022

Ann Transl Med

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Background: Esophageal cancer in China accounts for nearly half of the global esophageal cancer cases.The relationship between the occurrence of postoperative complications of esophageal cancer surgery and seasonal changes is not clear. Our purpose is to clarify the relationship between postoperative complications of esophageal cancer and season, so as to reduce the incidence of complications.Methods: We retrospectively analyzed the medical records of patients undergoing esophageal cancer surgery in our hospital between January 2013 and December 2014. Patients were divided into the summer group (March -August) and the non-summer group (September -February) according to the seasonal climate. Pulmonary, cardiac, and other complications were recorded. Differences in postoperative complications were compared between the two groups by the chi-squared test.Results: In the 251 patients enrolled, the total postoperative complication rate was 37.8%. The occurrence of incision complications in the summer group was significantly higher than that in the non-summer group (10.1% vs. 3.5%, P=0.044). Pulmonary and cardiac complications in summer group were significantly rarer than those in the non-summer group (16.7% vs. 27.4%, P=0.039; and 8.0% vs. 16.8%, P=0.032, respectively).Conclusions: During the warm months of the year, clinicians should focus on preventing postoperative incision complications, and they should focus on preventing pulmonary and cardiac complications during the cold months.

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“…Studies on the seasonal chronology of surgical complications regardless of the influence on 25(OH)D are limited. One preliminary study explored the seasonality pattern of perioperative adverse outcomes after bariatric surgery, denoting higher incidence of deep venous thrombosis and sepsis in colder seasons, and proposing the significance of seasonality ( 41 ). It is shown that the percentage of weight lost in the three months after bariatric surgery is higher during the summer months (July–November) ( 42 ).…”

Section: Discussionmentioning

confidence: 99%

Baseline 25(OH)D level is a prognostic indicator for bariatric surgery readmission: a matched retrospective cohort study

Shang,

Chen,

Wang

et al. 2024

Front. Nutr.

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IntroductionManaging postsurgical complications is crucial in optimizing the outcomes of bariatric surgery, for which preoperative nutritional assessment is essential. In this study, we aimed to evaluate and validate the efficacy of vitamin D levels as an immunonutritional biomarker for bariatric surgery prognosis.MethodsThis matched retrospective cohort study included adult patients who underwent bariatric surgery at a tertiary medical center in China between July 2021 and June 2022. Patients with insufficient and sufficient 25(OH)D (< 30 ng/mL) were matched in a 1:1 ratio. Follow-up records of readmission at 3 months, 6 months, and 1 year were obtained to identify prognostic indicators.ResultsA matched cohort of 452 patients with a mean age of 37.14 ± 9.25 years and involving 69.47% females was enrolled. Among them, 94.25 and 5.75% underwent sleeve gastrectomy and gastric bypass, respectively. Overall, 25 patients (5.54%) were readmitted during the 1-year follow-up. The prognostic nutritional index and controlling nutritional status scores calculated from inflammatory factors did not efficiently detect malnourishment. A low 25(OH)D level (3.58 [95% CI, 1.16–11.03]) and surgery season in summer or autumn (2.68 [95% CI, 1.05–6.83]) increased the risk of 1-year readmission in both the training and validation cohorts. The area under the receiver operating characteristic curve was 0.747 (95% CI, 0.640–0.855), with a positive clinical benefit in the decision curve analyses. The relationship between 25(OH)D and 6-month readmission was U-shaped.ConclusionSerum 25(OH)D levels have prognostic significance in bariatric surgery readmission. Hence, preferable 25(OH)D levels are recommended for patients undergoing bariatric surgery.

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Seasonality in the adverse outcomes in weight loss surgeries

Abstract: DVT and sepsis are more likely to occur in colder seasons compared with the summer season, although the crude rates of these adverse events were low.

Cited by 8 publications

References 40 publications

Seasonal or cyclical pattern in short-term postoperative outcomes of colorectal cancer? A time series analysis.

Seasonal or cyclical pattern in short-term postoperative outcomes of colorectal cancer? A time series analysis.

Relationship between postoperative complications of esophageal cancer surgery and season: a retrospective study

Baseline 25(OH)D level is a prognostic indicator for bariatric surgery readmission: a matched retrospective cohort study

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