Impact of Extremes of BMI on Outcomes following Lung Resection.

IF 1.3 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Thoracic and Cardiovascular Surgeon Pub Date : 2024-08-01 Epub Date: 2023-04-13 DOI:10.1055/a-2072-9869
Amber Ahmed-Issap, Shubham Jain, Akolade Habib, Kim Mantio, Angelica Spence, Marko Raseta, Udo Abah
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引用次数: 0

Abstract

Background:  Body mass index (BMI) has been shown to be an independent predictor of survival following lung resection surgery. This study aimed to quantify the short- to midterm impact of abnormal BMI on postoperative outcomes.

Methods:  Lung resections at a single institution were examined between 2012 and 2021. Patients were divided into low BMI (<18.5), normal/high BMI (18.5-29.9), and obese BMI (>30). Postoperative complications, length of stay, and 30- and 90-day mortality were examined.

Results:  A total of 2,424 patients were identified. Of these patients, 2.6% (n = 62) had a low BMI, 67.4% (n = 1,634) had a normal/high BMI, and 30.0% (n = 728) had an obese BMI. Overall postoperative complications were higher in the low BMI group (43.5%) when compared with normal/high (30.9%) and obese BMI group (24.3%) (p = 0.0002). Median length of stay was significantly higher in the low BMI group (8.3 days) compared with 5.2 days in the normal/high and obese BMI groups (p < 0.0001). Ninety-day mortality was higher in the low (16.1%) compared with the normal/high (4.5%) and obese BMI groups (3.7%) (p = 0.0006). Subgroup analysis of the obese cohort did not elucidate any statistically significant differences in overall complications in the morbidly obese. Multivariate analysis determined that BMI is an independent predictor of reduced postoperative complications (odds ratio [OR], 0.96; 95% confidence interval [CI], 0.94-0.97; p < 0.0001) and 90-day mortality (OR, 0.96; 95% CI, 0.92-0.99; p = 0.02).

Conclusion:  Low BMI is associated with significantly worse postoperative outcomes and an approximate fourfold increase in mortality. In our cohort, obesity is associated with reduced morbidity and mortality following lung resection surgery, confirming the existence of the obesity paradox.

极端体重指数对肺切除术后结果的影响
背景:身体质量指数(BMI)已被证明是肺切除手术后生存率的独立预测指标。本研究旨在量化异常体重指数对术后结果的中短期影响:方法:研究人员对 2012 年至 2021 年间在一家医疗机构进行的肺切除手术进行了调查。患者被分为低体重指数(30)、中体重指数(30)和高体重指数(30)。对术后并发症、住院时间、30 天和 90 天死亡率进行了研究:结果:共确定了 2424 名患者。在这些患者中,2.6%(n = 62)为低体重指数,67.4%(n = 1,634)为正常/高体重指数,30.0%(n = 728)为肥胖体重指数。低体重指数组(43.5%)的总体术后并发症高于正常/高体重指数组(30.9%)和肥胖体重指数组(24.3%)(P = 0.0002)。低体重指数组的住院时间中位数(8.3 天)明显高于正常/高体重指数组和肥胖体重指数组的 5.2 天(P = 0.0006)。对肥胖人群进行的亚组分析并未发现病态肥胖者在总体并发症方面存在任何统计学意义上的显著差异。多变量分析表明,体重指数是减少术后并发症的独立预测因素(几率比[OR],0.96;95% 置信区间[CI],0.94-0.97;P = 0.02):结论:低体重指数与较差的术后效果和约四倍的死亡率相关。在我们的队列中,肥胖与肺切除手术后发病率和死亡率的降低有关,证实了肥胖悖论的存在。
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来源期刊
CiteScore
3.40
自引率
6.70%
发文量
365
审稿时长
3 months
期刊介绍: The Thoracic and Cardiovascular Surgeon publishes articles of the highest standard from internationally recognized thoracic and cardiovascular surgeons, cardiologists, anesthesiologists, physiologists, and pathologists. This journal is an essential resource for anyone working in this field. Original articles, short communications, reviews and important meeting announcements keep you abreast of key clinical advances, as well as providing the theoretical background of cardiovascular and thoracic surgery. Case reports are published in our Open Access companion journal The Thoracic and Cardiovascular Surgeon Reports.
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