Metabolic Syndrome Exponentially Increases the Risk of Adverse Outcomes in Operative Diverticulitis

Jehan, Faisal; Zeeshan, Muhammad; Con, Jorge; Hanna, Kamil; Tang, Andrew; Hamidi, Mohammad; Latifi, Rifat; Joseph, Bellal

doi:10.1016/j.jss.2019.07.075

Cited by 9 publications

(11 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our finding that MetS is a stronger prognostic indicator compared to its individual constituents correlates with studies on the clinical outcomes of patients with SARS-CoV-2, 40 risk of atrial fibrillation, 41 colorectal cancer surgery, 42 hip and knee arthroplasty, 43 and operative diverticulitis. 44 Our study supplements the existing literature by reporting an increased risk for short-term medical complication among patient with MetS undergoing complex head and neck surgery. Importantly, this MetS cohort had a reduced rate of smoking compared to the non-MetS counterpart.…”

Section: Discussionsupporting

confidence: 70%

See 1 more Smart Citation

Association Between Metabolic Syndrome and Outcomes in Complex Head and Neck Surgery

Vasudev

Goshtasbi

Tjoa

et al. 2023

Ann Otol Rhinol Laryngol

View full text Add to dashboard Cite

Objectives: We aim to evaluate the impact of MetS on the short-term postoperative outcomes of complex head and neck surgery patients. Methods: This is a retrospective cohort analysis of the 2005 to 2017 National Surgical Quality Improvement Program (NSQIP) database. NSQIP database was queried for 30-day outcomes of patients undergoing complex head and neck surgeries, defined as laryngectomy or mucosal resection followed by free tissue transfer, similar to prior NSQIP studies. Patients with hypertension, diabetes, and body mass index (BMI) >30 kg/m2 were defined as having MetS. Adverse events were defined as experiencing readmission, reoperation, surgical/medical complications, or mortality. Results: A total of 2764 patients (27.0% female) with a mean age of 62.0 ± 11.7 years were included. Patients with MetS (n = 108, 3.9%) were more likely to be female ( P = .017) and have high ASA classification ( P = .030). On univariate analysis, patients with MetS were more likely to require reoperation (25.9% vs 16.7%, P = .013) and experience medical complications (26.9% vs 15.4% P = .001) or any adverse events (61.1% vs 48.7%, P = .011) compared to patients without MetS. On multivariate logistic regression after adjusting for age, sex, race, ASA classification, and complex head and neck surgery type, MetS was an independent predictor of medical complications (odds ratio 2.34, 95% CI 1.28-4.27, P = .006). Conclusion: Patients with MetS undergoing complex head and neck surgery are at increased risk of experiencing medical complications. Identifying patients with MetS can therefore aid surgeons in preoperative risk assessment and help improve postoperative management. Level of Evidence: N/A

show abstract

Section: Discussionsupporting

confidence: 70%

“…However, this is the standard utilized by past research on MetS utilizing the ACS-NSQIP database. 10,44 Finally, significant confounding variables may exist in the ACS-NSQIP database due to different institutional reporting and coding. Further institutional studies are needed to address these confounders.…”

Section: Discussionmentioning

confidence: 99%

Association Between Metabolic Syndrome and Outcomes in Complex Head and Neck Surgery

Vasudev

Goshtasbi

Tjoa

et al. 2023

Ann Otol Rhinol Laryngol

View full text Add to dashboard Cite

show abstract

“…Patients with metabolic syndrome also had longer recovery and higher rates of complications, readmissions, and mortality. 84 Bordeianou et al reported that 21% of patients with diverticulitis had surgical site infection. Obesity (BMI >30 kg/m 2 ), advanced age…”

Section: Postoperative Complications and Longterm Outcomesmentioning

confidence: 99%

“…After surgery for diverticulitis, patients with metabolic syndrome (BMI >30 kg/m 2 , hypertension, and DM) had more adverse events, such as reintubation, ventilator dependence more than 48 hours, myocardial infarction, and superficial or deep surgical site infections. Patients with metabolic syndrome also had longer recovery and higher rates of complications, readmissions, and mortality . Bordeianou et al reported that 21% of patients with diverticulitis had surgical site infection.…”

Section: Diverticulitismentioning

confidence: 99%

Essential updates 2018/2019: Colorectal (benign)

Ogino

Mizushima

Matsuda

et al. 2019

Annals of Gastroent Surgery

View full text Add to dashboard Cite

This review outlines current topics on the surgical treatment of benign colorectal diseases, with a focus on inflammatory bowel disease (IBD) and diverticulitis. Treatment options for IBD and diverticulitis have evolved in the last few years as a result of medical advances in technology and new clinical trials. Therefore, treatment options and strategies need to be updated to provide optimal care for patients. The purpose of this review is to elucidate recent global trends and update the surgical treatment strategy for IBD and diverticulitis based on literature published in the past 2 years. Prevalence of IBD, including ulcerative colitis and Crohn's disease, has increased over the last few decades. During this period, many new medical therapies were introduced for the treatment of IBD, including biological therapy, immunomodulators, and leukocyte apheresis therapy. As a result, new surgical strategies for IBD are required. In order to improve surgical outcomes in IBD patients, the influence of preoperative treatment on postoperative complications needs to be considered. The incidence of diverticulitis is also increasing with lifestyle changes and increasing numbers of older people. For diverticulitis with perforation and generalized peritonitis, surgery is the gold standard. Elective surgery after conservative treatment of diverticulitis is also an option because of high recurrence rates. With an increase in diverticulitis, systematic strategies are essential for an appropriate approach to diverticulitis, taking into account various factors, including the patient's background.

show abstract

“…There is growing evidence linking obesity to diverticulosis, severity and complications related to diverticular disease, and worse outcomes after surgery [12][13][14][15][16][17][18][19]. However, diverticular disease is not considered a weight related comorbidity to qualify for bariatric surgery [20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Should diverticulitis be considered a qualifying weight related comorbidity for bariatric surgery?

LaRocque

Russell

Nguyen

et al. 2022

Preprint

View full text Add to dashboard Cite

Introduction: With rising obesity rates, surgeons are operating on increasingly larger patients. Minimally invasive surgery has helped ease this burden on surgeons. However, we are still quantifying the impact of weight on surgical outcomes. The purpose of this study is to determine the role of obesity in elective laparoscopic colectomy for colonic diverticulitis. Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) and colectomy targeted procedure databases were queried from 2012-2019, examining patients undergoing elective, minimally invasive partial colectomy with or without primary anastomosis for an indication of diverticulitis. Patients with a BMI under 30 (non-obese) were compared to patients with a BMI between 35-40 (obese). The groups were propensity score matched for pre-operative and intra-operative variables. Results: 2,217 patients were identified with 1,954 non-obese patients and 263 obese patients. The groups’ average BMIs were 25.3 ± 3 and 37.1 ± 1.5, respectively. There were no significant differences between the two groups after a 2:1 propensity score match. In obese patients, there were higher rates of conversion to open (11.49% vs 7.09%, p =0.038), operative time (178.5 vs 167.0 minutes, p = 0.044), and readmission (7.28% vs 3.64%, p = 0.025). The leak rate was 4.98% for obese patients vs. 2.68% for non-obese patients, though this was not statistically significant (p=0.097). Conclusion: Obese patients undergoing elective laparoscopic colectomies for diverticulitis suffer from increased rates of conversion to open, operative time, and readmission. Diverticulitis should be strongly considered for inclusion as a qualifying weight related comorbidity for bariatric surgery as significant weight loss prior to diverticulitis surgery improves outcomes.

show abstract

Metabolic Syndrome Exponentially Increases the Risk of Adverse Outcomes in Operative Diverticulitis

Cited by 9 publications

References 33 publications

Association Between Metabolic Syndrome and Outcomes in Complex Head and Neck Surgery

Association Between Metabolic Syndrome and Outcomes in Complex Head and Neck Surgery

Essential updates 2018/2019: Colorectal (benign)

Should diverticulitis be considered a qualifying weight related comorbidity for bariatric surgery?

Contact Info

Product

Resources

About