Is obesity a risk factor for complications, hospital admissions, and surgical cancellations in ambulatory surgery?

García, M. Arance; Durántez, Fernando Docobo; Guzmán, C. Conde; Torres, M.C. Pérez; Parra, R. Martín-Gil; Jiménez, P.

doi:10.1016/j.redare.2014.03.004

Cited by 6 publications

(5 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A single institution, prospective study out of Spain suggested that obesity class II patients undergoing outpatient surgery had higher rates of post-operative complications, unplanned admissions, and surgical cancellations, although their data did not demonstrate a statistically significant difference. 10 Another study similarly found that while super-obese patients are at higher risk of same-day unplanned admission, their postoperative complication rates are no higher than that of their non-obese counterparts. 11 Other authors argue that BMI alone should not be the sole criterion for ambulatory surgery as BMI does not predetermine the risk of post-operative complications or unplanned admissions.…”

Section: Discussionmentioning

confidence: 96%

Morbid Obesity Not a Risk for Serious Complications Following Outpatient Surgery

Tumminello

Hogan

Leonardi

et al. 2022

The American Surgeon™

View full text Add to dashboard Cite

Patients with class III obesity are often excluded from surgery in ambulatory surgery centers (ASCs). We hypothesize that class III obesity is not a risk factor for serious post-operative complications following outpatient operations. ACS-NSQIP database from 2012 to 2018 was queried. Patients undergoing outpatient inguinal hernia repair (IHR) and laparoscopic cholecystectomy (LC) were grouped by BMI. Baseline characteristics and 30-day outcomes were compared using univariate and multivariate analyses. Of these, 79,916 patients underwent IHR and 107,471 patients underwent LC. Multivariable analysis in IHR showed increased odds of superficial SSIs in all classes of obesity compared to normal weight ( P < .0001). In the LC group, there were higher rates of SSIs with obesity ( P < .0001). For both surgeries, a higher rate of readmissions to the hospital were observed in class II and IIIa obesity (both P < .0001), although rates were relatively low (<3%). Class III obesity demonstrates a statistically significant increase in SSI following IHR and LC. Severe complications requiring readmission are not mirrored, suggesting the morbidly obese patients should be considered for routine surgical procedures in outpatient settings.

show abstract

Section: Discussionmentioning

confidence: 96%

Morbid Obesity Not a Risk for Serious Complications Following Outpatient Surgery

Tumminello

Hogan

Leonardi

et al. 2022

The American Surgeon™

View full text Add to dashboard Cite

show abstract

“…Unplanned readmission refers to readmission to hospital due to postoperative complications, wound infection, and so on after discharge during the follow‐up period of the study. Nine studies (Acevedo & Leon, 2010; Arance Garcia et al, 2015; Bowling et al, 2017; Gabriel et al, 2020; Gregori et al, 2018; Hofer et al, 2008; Livermore et al, 2011; Rosero & Joshi, 2014; Tandon et al, 2016) examined the association between BMI and unplanned readmission for day surgery patients, and they could be grouped in three ways: seven articles (Acevedo & Leon, 2010; Arance Garcia et al, 2015; Bowling et al, 2017; Gabriel et al, 2020; Gregori et al, 2018; Livermore et al, 2011; Tandon et al, 2016) were grouped by BMI >30 kg/m 2 versus BMI <30 kg/m 2 ; two articles were grouped by BMI ≤25 kg/m 2 versus BMI ≥40 kg/m 2 (Hofer et al, 2008; Rosero & Joshi, 2014). Whether we compared the impacts of higher versus lower BMI on unplanned readmission (nine articles) (Acevedo & Leon, 2010; Arance Garcia et al, 2015; Bowling et al, 2017; Gabriel et al, 2020; Gregori et al, 2018; Hofer et al, 2008; Livermore et al, 2011; Rosero & Joshi, 2014; Tandon et al, 2016) or compared the impact of BMI >30 kg/m 2 versus BMI <30 kg/m 2 on unplanned readmission (seven articles) (Acevedo & Leon, 2010; Arance Garcia et al, 2015; Bowling et al, 2017; Gabriel et al, 2020; Gregori et al, 2018; Livermore et al, 2011; Tandon et al, 2016), the pooled results indicated that higher BMI was not associated with increased risk of unplanned readmission for day surgery patients (odds ratio [OR], 0.93; 95% CI, 0.70–1.20; and OR, 0.90; 95% CI, 0.67–1.21, respectively).…”

Section: Resultsmentioning

confidence: 99%

“…These conditions often lead to difficult intubation, failure of intubation, prolonged mechanical ventilation time, anaesthetic drug accumulation, and secondary redistribution after recovery due to excessive fat, which can result in postoperative upper respiratory tract obstruction, incomplete recovery of lung function, reduction of pharyngeal muscle coordination and gastroesophageal reflux (Healy et al, 2007). The incidence of postoperative pain, nausea, and vomiting in obese patients has also increased significantly (Arance Garcia et al, 2015); acute postoperative pain affects the recovery of patients and severely affects the postoperative quality of life of the patient. Meanwhile, vomiting leads to dehydration and electrolyte disturbances in patients.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Association between obesity and risk of delayed discharge and unplanned readmission for day surgery: A systematic review and meta‐analysis

Xiao,

Dai,

Huang

2023

Int J of Nursing Practice

View full text Add to dashboard Cite

AimsThis work aims to investigate the association between obesity and risk of delayed discharge and unplanned readmission in day surgery patients.BackgroundDay surgeries are well received and developing rapidly. Associations between obesity and delayed discharge and unplanned readmission, which are clinically relevant outcomes in day surgeries, are complex.DesignA systematic review and meta‐analysis was conducted.Data SourcesThe PubMed, Web of Science, EMBASE, Cochrane Library, CNKI, VIP, and Wan Fang databases were comprehensively searched from inception until January 2021.Review MethodsTwo independent reviewers assessed the studies and extracted data. Pooled estimates were obtained using a random‐effects model.ResultsEleven articles published between 2007 and 2020 were finally included. Obesity appeared not to increase the risk of delayed discharge. However, morbid obesity seemed to be associated with a higher risk of delayed discharge. The meta‐analysis revealed no relationship between higher body mass index (BMI) and unplanned readmission for day surgery patients.ConclusionsObesity appeared not to increase the risk of delayed discharge except in patients with morbid obesity. Additionally, a higher BMI was not associated with increased risk of unplanned readmission after day surgery. Future studies are required to address this issue further in different types of surgery and areas.

show abstract

“…Subsequently, the studies evaluating the association between BMI and outcomes have been controversial. Several studies have reported that higher BMI increases the risk of complications and readmissions after ambulatory surgery 6‐8 . However, others could not confirm this association 9 …”

Section: Introductionmentioning

confidence: 99%

Finding the body mass index cutoff for hospital readmission after ambulatory hernia surgery

Rosero

Joshi

2020

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

Background The suitability of ambulatory surgery in obese patients remains controversial. This study aimed to investigate the “cutoff” value of body mass index (BMI) associated with increased likelihood of hospital readmissions within the first 24 hours of surgery in patients undergoing ambulatory hernia repair. Materials and Methods The study used data from the 2012‐2016 American College of Surgeons National Surgical Quality Improvement (ACS‐NSQIP). Cochran Armitage trend tests were conducted to assess progression in rates hospital readmissions across categories of patient BMI. The minimum p‐value method, Kolmogorov‐Smirnov goodness of fit tests, logistic regression, and receiver‐operating characteristic (ROC) curve analyses were used to investigate the cutoff of patient BMI indicative of increased likelihood of readmissions. Results A total of 214,125 ambulatory hernia repair cases were identified. Of those, 908 patients (0.42%) had an unexpected hospital admission within the first 24 hours after surgery. The readmission rates did not significantly increase across the categories of BMI. However, some of the reasons for readmission significantly differed by BMI category. Logistic regression analysis revealed no statistically significant association between BMI and hospital readmissions (odds ratio [95% Cl], 0.96 [0.91‐1.02] P = .179). An optimal BMI threshold predictive of an increased likelihood of hospital readmissions was not identifiable by any of the statistical methods used. Conclusions Although reasons for readmission differed by BMI category, there is no clear cutoff value of BMI associated with increased hospital readmission within the first 24 hours after surgery.

show abstract

Is obesity a risk factor for complications, hospital admissions, and surgical cancellations in ambulatory surgery?

Cited by 6 publications

References 20 publications

Morbid Obesity Not a Risk for Serious Complications Following Outpatient Surgery

Morbid Obesity Not a Risk for Serious Complications Following Outpatient Surgery

Association between obesity and risk of delayed discharge and unplanned readmission for day surgery: A systematic review and meta‐analysis

Finding the body mass index cutoff for hospital readmission after ambulatory hernia surgery

Contact Info

Product

Resources

About