Department of Pharmacy Services, Medical University of South Carolina, 280 Calhoun Street, MSC 132, Charleston, SC 29425, United States.
Department of Pharmacy Services, Medical University of South Carolina, 280 Calhoun Street, MSC 132, Charleston, SC 29425, United States.
Am J Surg. 2018 Apr;215(4):663-668. doi: 10.1016/j.amjsurg.2017.05.009. Epub 2017 Jun 8.
This study evaluated the impact of body mass index (BMI) and patient functional status on the risk for surgical complications after kidney transplant.
This retrospective cohort study of adult kidney transplant recipients grouped patients by baseline Karnofsky status (low function ≤ 70%) and further stratified by morbid obesity (BMI ≥ 35 kg/m) to assess surgical complication risk.
736 patients were included with surgical complications occurring in 25%. Logistic regression analysis with interaction terms demonstrated that morbid obesity and low functional status conditionally impact risk with an OR of 2.8 [95% CI (1.1-7.3)]. Within the functional status cohort, BMI ≥35 kg/m was associated with increased risk of surgical complication, superficial wound infection, and DGF. Independent predictors for surgical complications included diabetes and morbid obesity with low functional status. There was no significant difference in graft loss or death across the cohorts.
While neither morbid obesity nor poor functional status alone predicts increased complications, the combined presence is associated with significant increase in risk for surgical complications after renal transplantation.
本研究评估了体重指数（BMI）和患者功能状态对肾移植后手术并发症风险的影响。
本回顾性队列研究纳入了成年肾移植受者，根据基线 Karnofsky 状态（功能低下≤70%）将患者分组，并进一步根据病态肥胖（BMI≥35kg/m）进行分层，以评估手术并发症风险。
共纳入 736 例患者，发生手术并发症 25%。具有交互项的逻辑回归分析显示，病态肥胖和功能低下状态条件性地影响风险，比值比（OR）为 2.8（95%置信区间[CI]为 1.1-7.3）。在功能状态队列中，BMI≥35kg/m 与手术并发症、浅表伤口感染和 DGF 的风险增加相关。手术并发症的独立预测因素包括糖尿病和病态肥胖伴功能低下。各组间在移植物丢失或死亡方面无显著差异。
虽然病态肥胖或功能低下本身均不会增加并发症风险，但两者并存与肾移植后手术并发症风险显著增加相关。
