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Impact of Severe Obesity on Major Perioperative Complications for Prolapse Surgery.
Kisby, Cassandra K; Vermunt, Jane; Maciejko, Laura A; Abd El Aziz, Mohamed A; Perry, William; Occhino, John A.
Afiliación
  • Kisby CK; From the Division of Urogynecology, Duke Health, Durham, NC.
  • Vermunt J; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN.
  • Maciejko LA; Alix School of Medicine, Mayo Clinic, Rochester, MN.
  • Abd El Aziz MA; Department of Internal Medicine, Mercyone North Iowa, Mason City, IA.
  • Perry W; Divisions of Colorectal Surgery and.
  • Occhino JA; Urogynecology, Mayo Clinic, Rochester, MN.
Urogynecology (Phila) ; 2024 Jan 16.
Article en En | MEDLINE | ID: mdl-38373242
ABSTRACT
IMPORTANCE Obesity adds complexity to the decision of surgical approach for pelvic organ prolapse; data regarding perioperative complications are needed.

OBJECTIVE:

The aim of the study was to evaluate associations of body mass index (BMI) and surgical approach (vaginal vs laparoscopic) on perioperative complications. STUDY

DESIGN:

Patients who underwent prolapse surgery were identified via the Current Procedural Terminology codes from the American College of Surgeons National Surgical Quality Improvement Program database 2007-2018. Thirty-day major complications were compared across BMI to identify an inflection point, to create a dichotomous BMI variable. Multivariable logistic regression was used to assess the association between BMI and complications. An interaction term was introduced to evaluate for effect modification by operative approach.

RESULTS:

A total of 26,940 patients were identified (25,933 BMI < 40, 1,007 BMI ≥ 40). The proportion of patients experiencing a major complication was higher in the BMI ≥ 40 group (2.0 vs 1.1%, P = 0.007). In multivariate analysis, the odds of a major complication was 1.8 times higher for women with a BMI ≥ 40 (95% confidence interval, 1.1-2.9, P = 0.04). There was a significant interaction between operative approach and BMI; therefore, further analyses were restricted to either vaginal or laparoscopic operative approaches. Among women who underwent vaginal prolapse repair, there was no difference in the odds of a major complication (adjusted odds ratio, 1.4; 0.8-2.4; P = 0.06). Among women who underwent laparoscopic repair, those with a BMI ≥ 40 were 6 times more likely to have a major complication (adjusted odds ratio, 6.0; 2.5-14.6; P < 0.001).

CONCLUSIONS:

Body mass index ≥ 40 was associated with an increased odds of a 30-day major complication. This association was greatest in women who underwent a laparoscopic prolapse repair.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Urogynecology (Phila) Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Urogynecology (Phila) Año: 2024 Tipo del documento: Article Pais de publicación: Estados Unidos