"Being overweight or obese is known to impact a patient's ability to recover from surgery," said David H. Berger, MD, MHCM, co-author of the paper, MEDVAMC operative care line executive, and professor of surgery at BCM. "However, our study indicates abdominal fat is particularly relevant to abdominal surgical outcomes."
Dr. Berger and Courtney Balentine, MD, co-author of the paper and a fellow in surgical research at BCM, sought to find out if a patient's waist circumference could serve as a better indicator than body mass index (BMI) in determining whether a patient would have difficulty recovering from surgery. BMI is a common measurement that uses a person's height and weight to formulate a measure of overweight or obesity.
"It is our contention that BMI misses the nuances of obesity because it is unable to demonstrate where the fat is distributed on the patient," said Dr. Balentine.
The study of 150 patients who underwent rectal cancer surgery found heavier patients were twice as likely to experience complications than patients with a smaller waist circumference. Patients with a waist of 45 inches or more were three times more likely to experience surgical site infections and twice as likely to require reoperation after their initial surgery.
"This study provides important insight for surgeons planning to operate on a patient with heavy midline fat distribution," said Dr. Berger. "Necessary surgical procedures cannot be avoided, but surgeons may want to consider altering antibiotic dosages in order to better fight infection."
Past studies of BMI and surgical infections have had inconsistent findings. This study is the first using waist circumference as a predictor of short-term surgical complications.
Dr. Balentine will present these data on Monday, May 3 at 4:15 p.m. CT in 243, Ernest N. Morial Convention Center.
The Effect of Early-Onset Obe
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Digestive Disease Week