BODY MASS INDEX AND OUTCOMES IN PATIENTS UNDERGOING ABDOMINAL SURGERY: A PROSPECTIVE STUDY

Ashutosh Silodia, Shalabh Agrawal, Manish Joleya

Abstract


Background: Obesity has long been considered a risk factor for poor outcomes from a variety of surgical procedures, yet recent studies of critically and chronically ill patients suggest that overweight and obese patients may paradoxically have better outcomes or has no effect on outcome. This unexpected association between improved outcomes and mild obesity has been described as the “Obesity Paradox”(9).

Material and Methods: We conducted a prospective study of 275 patients undergoing abdominal surgery in NSCB Medical College, Jabalpur, from Feb 2015 to Sep 2016 to examine effect of BMI on postoperative day morbidity and mortality. A pre-operative proforma was filled after taking detailed history, examination and conducting few investigations for each patient. A post-operative proforma was filled after following the patient for 30 days.

Results: In our study, we found that out of total 275 patients, 84 (30.54%) were underweight, 150 (54.54%) were having normal BMI, 31 (11.27%) were overweight and 10 (3.63%) were obese. In our study, out of total 275 patients, 60 were female(21.8%) and 215 were male patients(78.2%). Mean duration of hospital stay was found to be 16 day in underweight group, 12 day in normal BMI group, 12 day in overweight group and 19 day in obese group. Mortality was present in 7(8.30%) out of 84 underweight patients, 3(2%) out of 150 normal BMI patients, 3(9.70%) out of 31 overweight patients and 1(10%) out of 10 obese patients. P value was found to be statistically significant for mortality in underweight patient and overweight patient. Underweight and obese patients had higher rate of wound dehiscence and SSI in comparison to normal BMI group.  We found that obesity was not an independent risk factor for post op complications such as post op pneumonia, unplanned intubation, renal insufficiency, thromboembolic complications, myocardial infarction, blood transfusions and urinary tract infections.

Conclusion: We found that being underweight is associated with high mortality in patients undergoing abdominal surgery. But obesity is not associated with high mortality in these patients. Our study confirms the existence of “obesity paradox”. We found that obesity was only an independent predictor of wound infection and not other post op complications.

Keywords


BMI, Abdominal surgery, Body mass index, Surgery, Obesity paradox, Mortality.

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