van Vugt Jeroen L A, Cakir Hamit, Kornmann Verena N N, Doodeman Hieronymus J, Stoot Jan H M B, Boerma Djamila, Houdijk Alexander P J, Hulsewé Karel W E
Department of Surgery, Orbis Medical Center, Sittard-Geleen, The Netherlands; Department of Surgery, St Antonius Hospital, Nieuwegein, The Netherlands.
Department of Surgery, Orbis Medical Center, Sittard-Geleen, The Netherlands; Department of Surgery, Medical Center Alkmaar, Alkmaar, The Netherlands.
Clin Nutr. 2015 Aug;34(4):700-4. doi: 10.1016/j.clnu.2014.08.006. Epub 2014 Aug 15.
BACKGROUND & AIMS: A new Body Mass Index (BMI) formula has been developed for a better approximation of under and overweight. The aim of this study was to investigate the predictive value of this newly proposed BMI formula for postoperative complications in elective colorectal cancer surgery compared with the conventional BMI formula.
A digital database of patients undergoing elective colorectal cancer surgery was prospectively maintained in three centers and retrospectively analyzed. Data consisted of patient characteristics, surgical procedure, length of hospital stay (LOS), postoperative complications, mortality, reoperation and readmission. The BMI was calculated using both the conventional and new BMI formula. Patients were divided into four groups (BMI <20, 20-25, 25-30, ≥30 kg/m(2)).
A total of 1614 patients were included. There was no significant difference in mean BMI between males and females using the conventional BMI formula (26.0 versus 26.2, p = 0.347), whereas a trend was observed using the new BMI formula (26.3 versus 25.6, p = 0.071). The proportion of overweight (BMI ≥25) male patients was significantly higher compared with the proportion of overweight female patients using the conventional formula (58.9% versus 51.0%, p = 0.021), whereas a non-significant difference was observed using the new formula (51.7% versus 53.4%, p = 0.515). Neither the conventional nor the new BMI were associated with postoperative complications and LOS. Higher age, higher ASA classification, male gender, and conventional surgery were independent predictors of the occurrence of postoperative complications. A longer LOS was also independently predicted by higher age, higher ASA classification and conventional surgery.
This study showed no superiority of the new BMI formula in predicting postoperative complications after colorectal cancer surgery. Confirmation of the results in a larger cohort is desirable.
已开发出一种新的体重指数（BMI）公式，以更好地估算体重过轻和超重情况。本研究的目的是调查与传统BMI公式相比，这种新提出的BMI公式对择期结直肠癌手术术后并发症的预测价值。
前瞻性地维护三个中心接受择期结直肠癌手术患者的数字数据库，并进行回顾性分析。数据包括患者特征、手术方式、住院时间（LOS）、术后并发症、死亡率、再次手术和再次入院情况。使用传统和新的BMI公式计算BMI。患者分为四组（BMI<20、20-25、25-30、≥30kg/m²）。
共纳入1614例患者。使用传统BMI公式时，男性和女性的平均BMI无显著差异（26.0对26.2，p=0.347），而使用新BMI公式时观察到一种趋势（26.3对25.6，p=0.071）。使用传统公式时，超重（BMI≥25）男性患者的比例显著高于超重女性患者的比例（58.9%对51.0%，p=0.021），而使用新公式时观察到无显著差异（51.7%对53.4%，p=0.515）。传统和新的BMI均与术后并发症和住院时间无关。年龄较大、美国麻醉医师协会（ASA）分级较高、男性性别和传统手术是术后并发症发生的独立预测因素。年龄较大、ASA分级较高和传统手术也可独立预测住院时间较长。
本研究表明，新的BMI公式在预测结直肠癌手术后的术后并发症方面并无优势。需要在更大的队列中证实这些结果。
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