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Surgical Endoscopy

Published in:

01-06-2016

The combined effect of age and body mass index on outcomes in foregut surgery: a regression model analysis of the National Surgical Quality Improvement Program data

Authors: Prashanth Palvannan, Irving Miranda, Aziz M. Merchant

Published in: Surgical Endoscopy | Issue 6/2016

Abstract

Background

In a parallel demographic phenomenon, the elderly and obese populations will become a larger part of our population and surgical practices. The elderly obese surgical risk profile is not clearly defined, although studies have confirmed their independent negative effect on surgical outcomes. Benign foregut surgery is a relatively common complex procedure performed on this demographic and warrants deeper investigation into outcomes. We investigate the synergistic effect of age and body mass index (BMI) on the outcomes of benign foregut surgery.

Methods

Data from National Surgical Quality Improvement Program were collected for all patients undergoing foregut surgery from 2005 to 2012. Subjects were over 18 years of age and 16 BMI. Primary and secondary outcomes were 30-day mortality and overall 30-day morbidity, respectfully. Binary logistic regression models were used to assess independent and interactive effects of age and BMI.

Results

A total of 19,547 patients had an average age and BMI of 57 and 29.7, respectively. Sample 30-day mortality was 0.32 %. Every 10-year age increase led to a 46 % increased odds of mortality. BMI showed a bimodal distribution with underweight and morbidly obese patients having increased mortality. The effect of BMI only became apparent with increasing age.

Conclusions

Both age and BMI are independent predictors of mortality; only older patients experienced the bimodal BMI effect. Therefore, increasing age and BMI have a synergistic effect on outcomes after foregut operations.

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Title: The combined effect of age and body mass index on outcomes in foregut surgery: a regression model analysis of the National Surgical Quality Improvement Program data
Authors: Prashanth Palvannan
Irving Miranda
Aziz M. Merchant
Publication date: 01-06-2016
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 6/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4529-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

The combined effect of age and body mass index on outcomes in foregut surgery: a regression model analysis of the National Surgical Quality Improvement Program data

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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