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660 The effect of body mass index on perioperative outcomes after major urologic surgery
Title
660
The effect of body mass index on perioperative outcomes after major urologic surgery Eur Urol Suppl 2015;14/2;e660
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Sood A. 1 , Abdollah F.1 , Sammon J. 1 , Klett D.E. 1 , Pucheril D.1 , Schmid M. 2 , Peabody J.O. 1 , Preston M.A.2 , Kibel A.S.2 , Menon M. 3 , Trinh Q-D.2 1 Henry
Ford Health System, VUI Center For Outcomes Research Analytics and Evaluation, Detroit, United States of America, 2 Brigham
and Women’s Hospital, Harvard Medical School, Dept. of Urologic Surgery and Center For Surgery and Public Health, Boston, United States of America, 3 Brigham and Women’s Hospital, Hrologic Surgery and Center For Surgery and Public Healtharvard Medica, Dept. of Urologic Surgery and Center For Surgery and Public Health, Boston, United States of America INTRODUCTION & OBJECTIVES: Obesity is associated with poor surgical outcomes and disparity in access-to-care. There is a lack of quality contemporary data on the effect of body-mass index (BMI) on perioperative outcomes. Hence, we sought to determine the procedure-specific independent-effect of BMI on 30-day surgical outcomes in patients undergoing major urologic surgery. MATERIAL & METHODS: Participants included individuals undergoing one of 3 major urologic surgery (prostate, bladder, kidney cancer; n=9,014) recorded in the ACS-NSQIP (2005-2011) database. Outcomes assessed included complications, blood-transfusion, length-of-stay (LOS), re-intervention, readmission and perioperative mortality. Multivariable logistic-regression models assessed the independent-effect of BMI on these outcomes. RESULTS: Nearly, 74% of all patients had a BMI disturbance, with the majority being either overweight (35.3%; BMI=25-29.9-kg/m 2 ) or obese (29.8%; BMI=30-39.9-kg/m 2 ). Morbidly-obese (BMI≥40-kg/m 2 ) and underweight patients (BMI<18.5-kg/m 2 ) constituted a small but significant proportion of the patients, 5.7% and 2.8%, respectively. In multivariable-analyses, morbidly-obese patients had significantly increased odds of wound complications in all 3 of the examined procedures, of renal complications after prostatectomy and cystectomy, of thromboembolism and UTI after prostatectomy (fig.1). Conversely, obese/overweight patients, except for increased odds of UTI after prostatectomy, did not experience increased odds for complications, rather had decreased odds for blood transfusion.
file:///S|/IM/EURSUP/2015%20EAU%20Abstracts/content/data/660.html[19/02/2015 08:18:07]
Title
CONCLUSIONS: The prevalence of BMI-derangements in urologic surgical patients is high. The effect of BMI on outcomes is procedurespecific. Patients with BMI between 18.5 and 40-kg/m 2 at time of surgery fare equally well with regards to complications. However, morbidly-obese patients are at high-risk for post-surgical complications, and thus, targeted preoperative-optimization may improve outcomes and attenuate disparity in access-to-care in these patients.
file:///S|/IM/EURSUP/2015%20EAU%20Abstracts/content/data/660.html[19/02/2015 08:18:07]
660
The effect of body mass index on perioperative outcomes after major urologic surgery Eur Urol Suppl 2015;14/2;e660
Print! Print!
Sood A. 1 , Abdollah F.1 , Sammon J. 1 , Klett D.E. 1 , Pucheril D.1 , Schmid M. 2 , Peabody J.O. 1 , Preston M.A.2 , Kibel A.S.2 , Menon M. 3 , Trinh Q-D.2 1 Henry
Ford Health System, VUI Center For Outcomes Research Analytics and Evaluation, Detroit, United States of America, 2 Brigham
and Women’s Hospital, Harvard Medical School, Dept. of Urologic Surgery and Center For Surgery and Public Health, Boston, United States of America, 3 Brigham and Women’s Hospital, Hrologic Surgery and Center For Surgery and Public Healtharvard Medica, Dept. of Urologic Surgery and Center For Surgery and Public Health, Boston, United States of America INTRODUCTION & OBJECTIVES: Obesity is associated with poor surgical outcomes and disparity in access-to-care. There is a lack of quality contemporary data on the effect of body-mass index (BMI) on perioperative outcomes. Hence, we sought to determine the procedure-specific independent-effect of BMI on 30-day surgical outcomes in patients undergoing major urologic surgery. MATERIAL & METHODS: Participants included individuals undergoing one of 3 major urologic surgery (prostate, bladder, kidney cancer; n=9,014) recorded in the ACS-NSQIP (2005-2011) database. Outcomes assessed included complications, blood-transfusion, length-of-stay (LOS), re-intervention, readmission and perioperative mortality. Multivariable logistic-regression models assessed the independent-effect of BMI on these outcomes. RESULTS: Nearly, 74% of all patients had a BMI disturbance, with the majority being either overweight (35.3%; BMI=25-29.9-kg/m 2 ) or obese (29.8%; BMI=30-39.9-kg/m 2 ). Morbidly-obese (BMI≥40-kg/m 2 ) and underweight patients (BMI<18.5-kg/m 2 ) constituted a small but significant proportion of the patients, 5.7% and 2.8%, respectively. In multivariable-analyses, morbidly-obese patients had significantly increased odds of wound complications in all 3 of the examined procedures, of renal complications after prostatectomy and cystectomy, of thromboembolism and UTI after prostatectomy (fig.1). Conversely, obese/overweight patients, except for increased odds of UTI after prostatectomy, did not experience increased odds for complications, rather had decreased odds for blood transfusion.
file:///S|/IM/EURSUP/2015%20EAU%20Abstracts/content/data/660.html[19/02/2015 08:18:07]
Title
CONCLUSIONS: The prevalence of BMI-derangements in urologic surgical patients is high. The effect of BMI on outcomes is procedurespecific. Patients with BMI between 18.5 and 40-kg/m 2 at time of surgery fare equally well with regards to complications. However, morbidly-obese patients are at high-risk for post-surgical complications, and thus, targeted preoperative-optimization may improve outcomes and attenuate disparity in access-to-care in these patients.
file:///S|/IM/EURSUP/2015%20EAU%20Abstracts/content/data/660.html[19/02/2015 08:18:07]