Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis

EuroSurg Collaborative

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien–Dindo Grades III–V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49–2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46–0.75, P < 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease.

Original languageEnglish
Pages (from-to)O215-O225
JournalColorectal Disease
Volume20
Issue number8
DOIs
Publication statusPublished - 2018 Aug 1

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Meta-Analysis
Body Mass Index
Cohort Studies
Obesity
Weights and Measures
Multicenter Studies
Emergencies
Multivariate Analysis
Prospective Studies

Keywords

  • Body mass index
  • Body weight
  • Digestive tract
  • Gastrointestinal tract
  • Obesity
  • Postoperative complications

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Body mass index and complications following major gastrointestinal surgery : A prospective, international cohort study and meta-analysis. / EuroSurg Collaborative.

In: Colorectal Disease, Vol. 20, No. 8, 01.08.2018, p. O215-O225.

Research output: Contribution to journalArticle

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abstract = "Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien–Dindo Grades III–V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2{\%}) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0{\%} vs 16.2{\%}, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95{\%} CI 1.49–2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95{\%} CI 0.46–0.75, P < 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease.",
keywords = "Body mass index, Body weight, Digestive tract, Gastrointestinal tract, Obesity, Postoperative complications",
author = "{EuroSurg Collaborative} and R. Blanco-Colino and S. Lee and Kamarajah, {S. K.} and P. Vasko and Kuiper, {S. Z.} and V. Farina and Chapman, {S. J.} and Drake, {T. M.} and L. Gavagna and S. Pasquali and F. Pata and G. Pellino and {de la Rosa-Estadella}, M. and Stellingwerf, {M. E.} and Stijns, {R. C.H.} and A. Borrellas and D. Golding and M. Ngaage and {Van Tol}, {R. R.} and {de Groof}, J. and {de Wilt}, H. and Bemelman, {W. A.} and L. McNamee and E. Espin-Basany and {Emre Baki}, B. and Gecim, {I. E.} and {Can Tatar}, O. and S. Bach and A. Bhangu and K. Bresges and J. Burke and Claireaux, {H. A.} and N. Fearnhead and Fitzgerald, {J. E.} and S. Gallagher and Glasbey, {J. C.} and B. Gundogan and Harrison, {E. M.} and J. Hernon and C. Khatri and Kong, {C. Y.} and A. Lyons and M. Mohan and D. Morton and Pinkney, {T. D.} and A. Arezzo and C. Foppa and M. Morino and M. Rubbini and Park, {Jong Jae}",
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T1 - Body mass index and complications following major gastrointestinal surgery

T2 - A prospective, international cohort study and meta-analysis

AU - EuroSurg Collaborative

AU - Blanco-Colino, R.

AU - Lee, S.

AU - Kamarajah, S. K.

AU - Vasko, P.

AU - Kuiper, S. Z.

AU - Farina, V.

AU - Chapman, S. J.

AU - Drake, T. M.

AU - Gavagna, L.

AU - Pasquali, S.

AU - Pata, F.

AU - Pellino, G.

AU - de la Rosa-Estadella, M.

AU - Stellingwerf, M. E.

AU - Stijns, R. C.H.

AU - Borrellas, A.

AU - Golding, D.

AU - Ngaage, M.

AU - Van Tol, R. R.

AU - de Groof, J.

AU - de Wilt, H.

AU - Bemelman, W. A.

AU - McNamee, L.

AU - Espin-Basany, E.

AU - Emre Baki, B.

AU - Gecim, I. E.

AU - Can Tatar, O.

AU - Bach, S.

AU - Bhangu, A.

AU - Bresges, K.

AU - Burke, J.

AU - Claireaux, H. A.

AU - Fearnhead, N.

AU - Fitzgerald, J. E.

AU - Gallagher, S.

AU - Glasbey, J. C.

AU - Gundogan, B.

AU - Harrison, E. M.

AU - Hernon, J.

AU - Khatri, C.

AU - Kong, C. Y.

AU - Lyons, A.

AU - Mohan, M.

AU - Morton, D.

AU - Pinkney, T. D.

AU - Arezzo, A.

AU - Foppa, C.

AU - Morino, M.

AU - Rubbini, M.

AU - Park, Jong Jae

PY - 2018/8/1

Y1 - 2018/8/1

N2 - Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien–Dindo Grades III–V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49–2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46–0.75, P < 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease.

AB - Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien–Dindo Grades III–V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49–2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46–0.75, P < 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease.

KW - Body mass index

KW - Body weight

KW - Digestive tract

KW - Gastrointestinal tract

KW - Obesity

KW - Postoperative complications

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JO - Colorectal Disease

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