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01-10-2015 | Original Article

Effects of body mass index (BMI) on surgical outcomes: a nationwide survey using a Japanese web-based database

Authors: Motonari Ri, Hiroaki Miyata, Susumu Aikou, Yasuyuki Seto, Kohei Akazawa, Masahiro Takeuchi, Yoshiro Matsui, Hiroyuki Konno, Mitsukazu Gotoh, Masaki Mori, Noboru Motomura, Shinichi Takamoto, Yoshiki Sawa, Hiroyuki Kuwano, Norihiro Kokudo

Published in: Surgery Today | Issue 10/2015

Abstract

Purpose

To define the effects of body mass index (BMI) on operative outcomes for both gastroenterological and cardiovascular surgery, using the National Clinical Database (NCD) of the Japanese nationwide web-based database.

Methods

The subjects of this study were 288,418 patients who underwent typical surgical procedures between January 2011 and December 2012. There were eight gastroenterological procedures, including esophagectomy, distal gastrectomy, total gastrectomy, right hemicolectomy, low anterior resection, hepatectomy of >1 segment excluding the lateral segment, pancreaticoduodenectomy, and surgery for acute diffuse peritonitis (n = 232,199); and five cardiovascular procedures, including aortic valve replacement, total arch replacement (TAR), descending thoracic aorta replacement (descending TAR), and on- or off-pump coronary artery bypass grafting (n = 56,219). The relationships of BMI with operation time and operative mortality for each procedure were investigated, using the NCD.

Results

Operation times were longer for patients with a higher BMI. When a BMI cut-off of 30 was used, the operation time for obese patients was significantly longer than that for non-obese patients, for all procedures except esophagectomy (P < 0.01). The mortality rate based on BMI revealed a U-shaped distribution, with both underweight and obese patients having high mortality rates for almost all procedures.

Conclusions

This Japanese nationwide study provides solid evidence to reinforce that both obesity and excessively low weight are factors that impact operative outcomes significantly.

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Title: Effects of body mass index (BMI) on surgical outcomes: a nationwide survey using a Japanese web-based database
Authors: Motonari Ri
Hiroaki Miyata
Susumu Aikou
Yasuyuki Seto
Kohei Akazawa
Masahiro Takeuchi
Yoshiro Matsui
Hiroyuki Konno
Mitsukazu Gotoh
Masaki Mori
Noboru Motomura
Shinichi Takamoto
Yoshiki Sawa
Hiroyuki Kuwano
Norihiro Kokudo
Publication date: 01-10-2015
Publisher: Springer Japan
Published in: Surgery Today / Issue 10/2015
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-015-1231-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Effects of body mass index (BMI) on surgical outcomes: a nationwide survey using a Japanese web-based database

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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