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Impact of preoperative body mass index and weight loss on morbidity and mortality following colorectal cancer—a retrospective cohort study
PURPOSE: Body weight and preoperative weight loss (WL) are controversially discussed as risk factors for postoperative morbidity and mortality in colorectal cancer surgery. The objective of this study is to determine whether body mass index (BMI) or WL is associated with a higher postoperative compl...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9436834/ https://www.ncbi.nlm.nih.gov/pubmed/35948668 http://dx.doi.org/10.1007/s00384-022-04228-1 |
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author | Axt, Steffen Wilhelm, Peter Spahlinger, Ricarda Rolinger, Jens Johannink, Jonas Axt, Lena Kirschniak, Andreas Falch, Claudius |
author_facet | Axt, Steffen Wilhelm, Peter Spahlinger, Ricarda Rolinger, Jens Johannink, Jonas Axt, Lena Kirschniak, Andreas Falch, Claudius |
author_sort | Axt, Steffen |
collection | PubMed |
description | PURPOSE: Body weight and preoperative weight loss (WL) are controversially discussed as risk factors for postoperative morbidity and mortality in colorectal cancer surgery. The objective of this study is to determine whether body mass index (BMI) or WL is associated with a higher postoperative complication rate. METHODS: In this retrospective cohort study, data analysis of 1241 consecutive patients undergoing colorectal cancer surgery in an 11-year period was performed. The main outcome measures were wound infections (WI), anastomotic leakages (AL), and in-house mortality. RESULTS: A total of 697 (56%) patients with colon and 544 (44%) with rectum carcinoma underwent surgery. The rate of WI for each location increased with rising BMI. The threshold value was 28.8 kg/m(2). Obese patients developed significantly more WI than normal-weight patients did following rectal resection (18.0% vs. 8.2%, p = 0.018). Patients with preoperative WL developed significantly more AL following colon resections than did patients without preoperative WL (6.2% vs. 2.5%, p = 0.046). In-house mortality was significantly higher in obese patients following colon resections than in overweight patients (4.3% vs. 0.4%, p = 0.012). Regression analysis with reference to postoperative in-house mortality revealed neither increased BMI nor WL as an independent risk factor. CONCLUSIONS: Increased preoperative BMI is associated with a higher WI rate. AL rate after colon resection was significantly higher in patients showing preoperative WL. Preoperative BMI and WL are therefore risk factors for postoperative morbidity in this study. Nevertheless, this has to be further clarified by means of prospective studies. Trial registration DRKS00025359, 21.05.2021, retrospectively registered. |
format | Online Article Text |
id | pubmed-9436834 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-94368342022-09-03 Impact of preoperative body mass index and weight loss on morbidity and mortality following colorectal cancer—a retrospective cohort study Axt, Steffen Wilhelm, Peter Spahlinger, Ricarda Rolinger, Jens Johannink, Jonas Axt, Lena Kirschniak, Andreas Falch, Claudius Int J Colorectal Dis Research PURPOSE: Body weight and preoperative weight loss (WL) are controversially discussed as risk factors for postoperative morbidity and mortality in colorectal cancer surgery. The objective of this study is to determine whether body mass index (BMI) or WL is associated with a higher postoperative complication rate. METHODS: In this retrospective cohort study, data analysis of 1241 consecutive patients undergoing colorectal cancer surgery in an 11-year period was performed. The main outcome measures were wound infections (WI), anastomotic leakages (AL), and in-house mortality. RESULTS: A total of 697 (56%) patients with colon and 544 (44%) with rectum carcinoma underwent surgery. The rate of WI for each location increased with rising BMI. The threshold value was 28.8 kg/m(2). Obese patients developed significantly more WI than normal-weight patients did following rectal resection (18.0% vs. 8.2%, p = 0.018). Patients with preoperative WL developed significantly more AL following colon resections than did patients without preoperative WL (6.2% vs. 2.5%, p = 0.046). In-house mortality was significantly higher in obese patients following colon resections than in overweight patients (4.3% vs. 0.4%, p = 0.012). Regression analysis with reference to postoperative in-house mortality revealed neither increased BMI nor WL as an independent risk factor. CONCLUSIONS: Increased preoperative BMI is associated with a higher WI rate. AL rate after colon resection was significantly higher in patients showing preoperative WL. Preoperative BMI and WL are therefore risk factors for postoperative morbidity in this study. Nevertheless, this has to be further clarified by means of prospective studies. Trial registration DRKS00025359, 21.05.2021, retrospectively registered. Springer Berlin Heidelberg 2022-08-11 2022 /pmc/articles/PMC9436834/ /pubmed/35948668 http://dx.doi.org/10.1007/s00384-022-04228-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/ Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Research Axt, Steffen Wilhelm, Peter Spahlinger, Ricarda Rolinger, Jens Johannink, Jonas Axt, Lena Kirschniak, Andreas Falch, Claudius Impact of preoperative body mass index and weight loss on morbidity and mortality following colorectal cancer—a retrospective cohort study |
title | Impact of preoperative body mass index and weight loss on morbidity and mortality following colorectal cancer—a retrospective cohort study |
title_full | Impact of preoperative body mass index and weight loss on morbidity and mortality following colorectal cancer—a retrospective cohort study |
title_fullStr | Impact of preoperative body mass index and weight loss on morbidity and mortality following colorectal cancer—a retrospective cohort study |
title_full_unstemmed | Impact of preoperative body mass index and weight loss on morbidity and mortality following colorectal cancer—a retrospective cohort study |
title_short | Impact of preoperative body mass index and weight loss on morbidity and mortality following colorectal cancer—a retrospective cohort study |
title_sort | impact of preoperative body mass index and weight loss on morbidity and mortality following colorectal cancer—a retrospective cohort study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9436834/ https://www.ncbi.nlm.nih.gov/pubmed/35948668 http://dx.doi.org/10.1007/s00384-022-04228-1 |
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