Alizadeh Reza Fazl, Moghadamyeghaneh Zhobin, Whealon Matthew D, Hanna Mark H, Mills Steven D, Pigazzi Alessio, Stamos Michael J, Carmichael Joseph C
Department of Surgery, School of Medicine, University of California, Irvine, Orange, California, USA.
Am Surg. 2016 Oct;82(10):930-935.
There are limited data regarding the association between body mass index (BMI) and colorectal surgery outcomes. We sought to evaluate the effect of BMI on short-term surgical outcomes in colon and rectal surgery patients in the United States. The American College of Surgeons National Surgery Quality Improvement Project database was used to identify all patients who underwent colon or rectal resection from 2005 to 2013. Multivariate regression analysis was used to assess the independent effect of BMI on outcomes. A total of 206,360 patients underwent colorectal resection during the study period. Of these, 3.2 per cent of patients were underweight (BMI < 18.5), 23.8 per cent patients were normal weight (18.5 ≤ BMI < 25), 26.5 per cent were overweight (25 ≤ BMI < 30), 25.2 per cent were obese (30 ≤ BMI < 40), and 5.3 per cent were morbidly obese (BMI ≥ 40). Underweight patients had longer length of stay (confidence interval: 2.70-3.49, P < 0.001) and higher mortality (adjusted odds ratio: 1.45, P < 0.01) compared with patients with a normal BMI. Morbidly obese patients had the highest overall morbidity rate compared with normal BMI patients (adjusted odds ratio: 1.53, confidence interval: 1.42-1.64, P < 0.01). BMI is associated with outcomes in colon and rectal surgery patients. Underweight and morbidly obese patients have a significantly increased risk of postsurgical complications compared with those with normal BMI.
关于体重指数（BMI）与结直肠手术结果之间的关联，现有数据有限。我们试图评估BMI对美国结肠和直肠手术患者短期手术结果的影响。利用美国外科医师学会国家手术质量改进项目数据库，确定了2005年至2013年期间所有接受结肠或直肠切除术的患者。采用多变量回归分析来评估BMI对结果的独立影响。在研究期间，共有206,360例患者接受了结直肠切除术。其中，3.2%的患者体重过轻（BMI<18.5），23.8%的患者体重正常（18.5≤BMI<25），26.5%的患者超重（25≤BMI<30），25.2%的患者肥胖（30≤BMI<40），5.3%的患者病态肥胖（BMI≥40）。与BMI正常的患者相比，体重过轻的患者住院时间更长（置信区间：2.70 - 3.49，P<0.001）且死亡率更高（调整后的优势比：1.45，P<0.01）。与BMI正常的患者相比，病态肥胖患者的总体发病率最高（调整后的优势比：1.53，置信区间：1.42 - 1.64，P<0.01）。BMI与结肠和直肠手术患者的手术结果相关。与BMI正常的患者相比，体重过轻和病态肥胖的患者术后并发症风险显著增加。
