Association between preoperative body mass index and postoperative short-term outcomes in patients undergoing pancreaticoduodenectomy: a multicenter study.

Abstract

Background: Pancreaticoduodenectomy (PD) is regarded as a highly complex procedures with high morbidity. This study aims to investigate the association between preoperative body mass index (BMI) and postoperative short-term outcomes in patients after PD.

Methods: Patients enrolled in this multicenter study were categorized into three groups based on preoperative BMI: low-BMI group (BMI <18.5 kg/m²), normal-BMI group (18.5≤ BMI <25.0 kg/m²), and high-BMI group (BMI ≥25.0 kg/m²). The baseline characteristics, intraoperative variables, and short-term postoperative outcomes of the patients were compared. Univariable and multivariable analyses were conducted to identify the risk factors for mortality and morbidity following PD.

Results: Among the 658 patients, 64 (9.7%), 475 (72.2%), and 119 (18.1%) were low-BMI, normal-BMI, and high-BMI, respectively. Compared with normal-BMI group, the mortality and morbidity were significantly higher in the low-BMI group (6.3% vs. 1.5%, P=0.03; 64.1% vs. 49.3%, P<0.001) and high-BMI group (5.0% vs. 1.5%, P=0.03; 67.2% vs. 49.3%, P<0.001). Multivariable analyses revealed that both low-BMI and high-BMI were independently associated with increased mortality [odds ratio (OR) 4.220, 95% confidence interval (CI): 1.133-15.712, P=0.03, and OR 4.046, 95% CI: 1.262-12.976, P=0.02] and overall morbidity (OR 2.084, 95% CI: 1.135-3.827, P=0.02, and OR 2.364, 95% CI: 1.462-3.822, P<0.001). Similar results were also observed for the incidence of clinically relevant postoperative pancreatic fistula (CR-POPF).

Conclusions: Patients with low-BMI and high-BMI had elevated postoperative mortality and morbidity, as well as an increased risk of CR-POPF following PD.