The influence of body mass index on the prevalence of complications after vaginal and abdominal hysterectomy

Rasmussen, Kirsten; Neumann, G; Ljungstrøm, Britt; Hansen, Viggo; Lauszus, Finn Friis

doi:10.1111/j.1600-0412.2004.00285.x

Cited by 35 publications

(11 citation statements)

References 13 publications

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“…Fifty‐six studies examined incidence of post‐surgical infections and complications in patients who were obese, compared with those who were normal weight. Fifty‐four of the studies reported increased complications associated with obesity . Thirteen of 56 of the studies reported higher incidence of infection, 20 of the 56 found an increase in surgical site infections, six of the studies found higher degrees of deep sternal wound infections and 14 studies reported other types of post‐operative complications such as re‐hospitalization.…”

Section: Resultsmentioning

confidence: 99%

Interaction of obesity and infections

2015

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There is evidence that certain infections may induce obesity. Obese persons may also have more severe infections and have compromised response to therapies. The objective of this study is to review the available literature identifying infections that potentially contribute to greater body mass index (BMI) and differential responses of overweight and obese persons to infections. A systematic literature review of human studies examining associations between infections and weight gain, differential susceptibility, severity, and response to prevention and treatment of infection according to BMI status (January 1980-July 2014) was conducted. Three hundred and forty-three studies were eligible for inclusion. Evidence indicated that viral infection by human adenovirus Ad36 and antibiotic eradication of Helicobacter pylori were followed by weight gain. People who were overweight or obese had higher susceptibility to developing post-surgical infections, H1N1 influenza and periodontal disease. More severe infections tended to be present in people with a larger BMI. People with a higher BMI had a reduced response to vaccinations and antimicrobial drugs. Higher doses of antibiotics were more effective in obese patients. Infections may influence BMI, and BMI status may influence response to certain infections, as well as to preventive and treatment measures. These observations have potential clinical implications.

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Section: Resultsmentioning

confidence: 99%

Interaction of obesity and infections

2015

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“…Others studies showed opposing results. A study that evaluated complications after hysterectomy showed no associations between BMI and risk of infections ( 31 ). In another study, the risk of infections was elevated among women with BMI < 20 kg/m2, who underwent laparoscopic surgery ( 32 ).…”

Section: Discussionmentioning

confidence: 99%

Association Between Body Mass Index and Urinary Tract Infection in Adult Patients

et al. 2014

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Background:Overweight and obesity have become a global public health over the last decades. Obesity has been suggested to be a risk factor for some infections, but studies often showed controversial findings. Few studies examined the relationship between body mass index (BMI) and urinary tract infection (UTI), showing inconsistent results.Objectives:The purpose of this study was to determine the relationship between BMI and UTI in adult patients.Patients and Methods:Adult patients (≥ 18 years old) who were referred to clinics or admitted in hospital with diagnosis of UTI were considered for participation in the study. Control group were selected from healthy adult normal population whom underwent medical check-ups at the same hospital and without history of UTI. Data about age, gender, history of diabetes mellitus and BMI were registered for individuals who met inclusion criteria.Results:A total of 116 patients with UTI and 156 people as the control group were included in the study. Two groups were matched for age, gender and history of diabetes mellitus. Mean BMI ± SD of patients was 25.2 ± 4.0 kg/m2 and the controls was 25.1 ± 3.6 kg/m2. There was no significant correlation between BMI and UTI (P = 0.757). Mean BMI ± SD of patients with upper UTI was 25.6 ± 4.1 kg/m2 and for lower UTI was 24.9 ± 4.0 kg/m2. There was no significant difference between BMI of controls and patients with any type of UTI (P = 0.573).Conclusions:Our findings did not found an association between BMI and UTI and does not support obesity as a risk factor for UTI in adult patients.

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“…7,13,27,34,40,43,47 Obese patients have also been reported to have worse outcomes after blunt trauma. This includes reports in the gynecological, orthopedic, cardiovascular, urological, and transplantation literature.…”

Section: Prevalence Of Obesity In Patients Undergoing Elective Thoracmentioning

confidence: 99%

Obesity and spine surgery: relation to perioperative complications

Patel

Bagan

Vadera

et al. 2007

SPI

398

176

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Object Many patients undergoing elective thoracic or lumbar fusion procedures are obese, but the contribution of obesity to complications in spine surgery has not been defined. The authors retrospectively assessed the prevalence of obesity in a cohort of patients undergoing thoracic and lumbar fusion and correlate the presence of obesity with the incidence of operative complications. Methods A retrospective review of consecutive patients treated by a single surgeon (J.K.R.) over a 36-month period at either Rush University Medical Center or the Neurological and Orthopedic Institute of Chicago was performed. The authors identified 332 elective thoracic and lumbar spine surgery cases; the cohort was restricted to include only patients with symptomatic degenerative conditions in need of an anterior, posterior, or combined anterior–posterior fusion. Cases of trauma, tumor, and infection and any case in which the procedure was performed for emergency indications were excluded. A total of 97 cases were identified; of these 86 procedures performed in 84 patients had adequate follow-up material for inclusion in the present study. A broad definition of complications was used. Complications were divided into adverse events (minor) and significant complications (major) based on their impact on patient outcome. Stepwise multivariate logistic regression was used to identify which variables had a significant effect on the risk of complications. Variables considered were body mass index (BMI), height, weight, age, sex, presence or absence of diabetes mellitus (DM) and/or hypertension, number of levels fused (single compared with multiple), and type of surgery performed. The mean BMI for the cohort was 28.8 (95% confidence interval 24.4–30.3); 60 patients (71.4%) were considered overweight or obese (BMI ≥ 25). There were 42 complications in 31 patients (36.9%); this included 19 significant complications in 17 patients (20.2%). Logistic regression revealed that the probability of a significant complication was related to BMI (p < 0.04); the chance of a significant complication was 14% with a BMI of 25, 20% with a BMI of 30, and 36% with a BMI of 40. Positioning-related palsies were only found in extremely obese patients (BMI ≥ 40). The probability of minor complication occurrence increased with age (p < 0.02), not BMI. The rate of complications was independent of sex as well as the presence of DM or hypertension. A standard collection of complications occurred, including wound infection (three cases), cerebrospinal fluid leakage (eight cases, one requiring reoperation), deep vein thrombosis (two cases), cardiac events (four cases), symptomatic pseudarthrosis (one case), pneumonia (three cases), prolonged intubation (two cases), urological issues (eight cases), positioning-related palsy (two cases), and neuropathic pain (two cases). Conclusions Obesity is a prevalent condition in patients undergoing elective fusion for degenerative spinal conditions and may increase the prevalence and incidence of perioperative complications. In their analysis, the authors correlated increasing BMI and increased risk of significant postoperative complications. The correlation of obesity and perioperative complications may assist in the preoperative evaluation and selection of patients for surgery.

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The influence of body mass index on the prevalence of complications after vaginal and abdominal hysterectomy

Cited by 35 publications

References 13 publications

Interaction of obesity and infections

Interaction of obesity and infections

Association Between Body Mass Index and Urinary Tract Infection in Adult Patients

Obesity and spine surgery: relation to perioperative complications

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