Waist Circumference and Waist/Hip Ratio Are Better Predictive Risk Factors for Mortality and Morbidity after Colorectal Surgery Than Body Mass Index and Body Surface Area

Kartheuser, Alex; Léonard, Daniel; Penninckx, Freddy; Paterson, Hugh; Brandt, Dimitri; Remue, Christophe; Bugli, Céline; Dozois, Eric J.; Mortensen, Neil; Ris, Frédéric; Tiret, Emmanuel

doi:10.1097/sla.0b013e3182a6605a

Cited by 81 publications

(50 citation statements)

References 39 publications

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“…Abdominal obesity, which can be measured by the waist to hip ratio, waist circumference, and waist to height ratio, may be more predictive of cardiovascular morbidity and mortality compared with BMI (28)(29)(30)(31). The waist to hip ratio is associated with both medical and surgical complications after elective abdominal surgery (32). Estrogen causes fat to be stored in the buttocks, thighs, and hips in Separate multivariate Cox regression models were performed in men and women for the outcome of activation to the waiting list, and transplantation from a deceased donor after wait-listing.…”

Section: Discussionmentioning

confidence: 99%

Differential Association of Body Mass Index with Access to Kidney Transplantation in Men and Women

Gill

Hendren

Dong

et al. 2014

Clinical Journal of the American Society of Nephrology

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Background and objectives Obese patients encounter barriers to medical care not encountered by lean patients, and inequities in access to care among obese patients may vary by sex. This study aimed to determine the association of body mass index (BMI) with access to kidney transplantation in men and women.Design, setting, participants, & measurements In this retrospective analysis of 702,456 incident ESRD patients aged 18-70 years (captured in the US Renal Data System between 1995 and 2007), multivariate time-to-event analyses were used to determine the association of BMI with likelihood of transplantation from any donor source, transplantation from a living donor, and transplantation from a deceased donor, as well the individual steps in obtaining a deceased donor transplant (activation to the waiting list, and transplantation after wait-listing).Results Among women, a BMI$25.0 kg/m 2 was associated with a lower likelihood of transplantation from any donor source (hazard ratio [HR], 0.75; 95% confidence interval [95% CI], 0.73 to 0.77), transplantation from a living donor (HR, 0.75; 95% CI, 0.72 to 0.77), and transplantation from a deceased donor (HR, 0.74; 95% CI, 0.72 to 0.77). By contrast, among men, a BMI of 25.0-34.9 kg/m 2 was associated with a higher likelihood of the outcomes of transplantation from any donor source (HR, 1.08; 95% CI, 1.06 to 1.11), transplantation from a living donor (HR, 1.18; 95% CI, 1.13 to 1.22), and transplantation from a deceased donor (HR, 1.05; 95% CI, 1.02 to 1.07). Among men, the level beyond which BMI was associated with a lower likelihood of transplantation from any donor source or a living donor was $40.0 kg/m 2 , and $35.0 kg/m 2 in the case of deceased donor transplantation. ConclusionsThe association of BMI with access to transplantation varies between men and women. The reasons for this difference should be further studied.Clin J Am Soc Nephrol 9: 951-959, 2014.

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Section: Discussionmentioning

confidence: 99%

Differential Association of Body Mass Index with Access to Kidney Transplantation in Men and Women

Gill

Hendren

Dong

et al. 2014

Clinical Journal of the American Society of Nephrology

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“…Another study published in 2013 proved that waist-hip-ration (as a measure of central obesity) had a significant influence in negative outcomes after CRC surgery, namely reoperation, medical complications, intraoperative complications and conversion to open approach, being this prediction effect superior to the one verified when measuring BMI and or WC [15]. Obesity was also associated with an increase in anastomotic leakage after rectal cancer resection [16].…”

Section: Introductionmentioning

confidence: 99%

The influence of metabolic syndrome in the outcomes of colorectal cancer patients

Goulart

Varejão

Nogueira

et al. 2017

Diabetes & Metabolic Syndrome: Clinical Research & Revi

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A B S T R A C TAims: Determine the influence of metabolic syndrome and its different components in the outcomes of colorectal cancer surgery at 30 days. Materials and methods: Prospective study that included all patients submitted to elective colorectal cancer surgery between August 2015 and August 2016 at Hospital de Braga. Clinical and laboratory parameters evaluated pre-operatively were: central obesity, blood pressure, fasting glucose, triglycerides levels and HDL cholesterol levels. Any complications during the first 30-days after surgery were recorded (readmission, reintervention, anastomotic dehiscence, morbimortality). Results: One hundred and thirty-four patients were included. Metabolic syndrome was diagnostic in 40.7% of patients with the ATPIII definition, 67.5% with the AHA definition and 67.0% with the IDF definition. At 30 days after colorectal cancer surgery, 73.1% patients don't have any complication, 15.7% have minor complications (grade I/II of Clavien-Dindo classification), 11.1% have major complications (grade III/IV/V of Clavien-Dindo classification) and 1.5% have died from surgical complications (grade V of Clavien-Dindo classification). The statistic analysis didn't reveal any association between MS, or it's different components, and surgical outcomes. Conclusion: This study seems to indicate that metabolic syndrome don't have any influence in surgical outcomes of colorectal cancer surgery.

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“…Other biometric parameters that have been evaluated include waist to hip ratio (WHR), which has been identified as a predictor of adverse events including conversion. 16 However, it has been found to correlate poorly with changes in visceral fat. 17 In our experience, the most challenging patients are those in whom there is a large amount of intra-abdominal fat rather than those who are simply overweight.…”

Section: Discussionmentioning

confidence: 99%

Abdominal fat ratio – a novel parameter for predicting conversion in laparoscopic colorectal surgery

Farid

Mann

et al. 2017

annals

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INTRODUCTION Laparoscopic surgery has become the standard for colorectal cancer resection in the UK but it can be technically challenging in patients who are obese. Patients whose body fat is mainly inside the abdominal cavity are more challenging than those whose fat is mainly outside the abdominal cavity. Abdominal fat ratio (AFR) is a simple parameter proposed by the authors to aid identification of this subgroup. MATERIALS AND METHODS All 195 patients who underwent elective, laparoscopic colorectal cancer resections from March 2010 to November 2013 were included in the study. For patients who were obese (body mass index greater than 30), preoperative staging computed tomography was used to determine AFR. This was assessed by two different, blinded observers and compared with conversion rate. RESULTS Of the 195 patients, 58 (29.7%) fell into the obese group and 137 (70.3%) into the non-obese group. The median AFR of the obese group that were converted to open surgery was significantly higher at 5.9 compared with those completed laparoscopically (3.3, P = 0.0001, Mann-Whitney). There was no significant difference in conversion rate when looking at body mass index, tumour site or size. DISCUSSION Previous studies have found body mass index, age, gender, previous abdominal surgery, site and locally advanced tumours to be associated with an increased risk of conversion. This study adds AFR to the list of risk factors. CONCLUSION AFR is a simple, reproducible parameter which can help to predict conversion risk in obese patients undergoing colorectal cancer resection.

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Waist Circumference and Waist/Hip Ratio Are Better Predictive Risk Factors for Mortality and Morbidity after Colorectal Surgery Than Body Mass Index and Body Surface Area

Abstract: The WHR is predictive of adverse events after elective colorectal surgery. It should be used in routine clinical practice and in future risk-estimating systems.

Cited by 81 publications

References 39 publications

Differential Association of Body Mass Index with Access to Kidney Transplantation in Men and Women

Differential Association of Body Mass Index with Access to Kidney Transplantation in Men and Women

The influence of metabolic syndrome in the outcomes of colorectal cancer patients

Abdominal fat ratio – a novel parameter for predicting conversion in laparoscopic colorectal surgery

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