波多黎各人群的体重指数与手术结果

Body Mass Index and Surgical Outcome in a Puerto Rican Population.

作者信息

Cruz Norma I, Lopez Luis A, Santiago Elvis

机构信息

Department of Surgery, School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, PR.

出版信息

P R Health Sci J. 2018 Sep;37(3):165-169.

PMID:30188561

Abstract

OBJECTIVE

To determine the impact of body mass index (BMI) on postoperative morbidity and 30-day mortality in the population served by the University of Puerto Rico (UPR)-affiliated hospitals.

METHODS

We reviewed the surgical data entered into the UPR General Surgery Department database from January 1, 2014, through June 30, 2016. This database collects patient and procedural information from the UPR-affiliated hospitals. We compared the postoperative morbidity and 30-day mortality rates of 5 different BMI groups: underweight (<18.5 kg/m2), normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), obese, classes I and II (30-39.9 kg/m2), and morbidly obese (>=40 kg/m2). Multivariable regression analyses, adjusted for age, gender, and surgery type, were used to evaluate the risks for each BMI category.

RESULTS

Information on 9,856 patients was reviewed. The mean age of the sample population was 52 (±20) years; 57% were women and 43% were men. The postoperative morbidity and 30-day mortality rates of the underweight group were significantly higher than those of the normal-weight group (6.1% vs. 3.1% and 2.1% vs. 0.5%, respectively; p<0.001). The morbidly obese also had significantly higher (p<0.001) postoperative morbidity (5.3% vs. 2.1%) and 30-day mortality rates (2.7% vs. 0.5%) compared to normal-weight patients. The odds of 30-day mortality were significantly higher for the underweight (odds ratio [OR], 5.64; 95% confidence interval [CI], 2.47-12.92) and morbidly obese patients (OR, 7.23; 95% CI, 3.01-17.39). The overweight patients had no increased risk, and the obese patients had a slight increase in morbidity (OR, 1.54; 95% CI, 1.08-2.21) but no significant increase in 30-day mortality (p>0.05).

CONCLUSION

Patients at the extremes of the BMI have more postoperative complications and higher 30-day mortality rates than do patients with mid-range scores.

摘要

目的

确定体重指数（BMI）对波多黎各大学（UPR）附属医院所服务人群术后发病率和30天死亡率的影响。

方法

我们回顾了2014年1月1日至2016年6月30日录入UPR普通外科数据库的手术数据。该数据库收集了UPR附属医院的患者和手术信息。我们比较了5个不同BMI组的术后发病率和30天死亡率：体重过轻（<18.5 kg/m²）、正常体重（18.5 - 24.9 kg/m²）、超重（25.0 - 29.9 kg/m²）、I级和II级肥胖（30 - 39.9 kg/m²）以及病态肥胖（>=40 kg/m²）。采用多变量回归分析，并对年龄、性别和手术类型进行校正，以评估每个BMI类别的风险。

结果

共回顾了9856例患者的信息。样本人群的平均年龄为52（±20）岁；57%为女性，43%为男性。体重过轻组的术后发病率和30天死亡率显著高于正常体重组（分别为6.1%对3.1%和2.1%对0.5%；p<0.001）。与正常体重患者相比，病态肥胖患者的术后发病率（5.3%对2.1%）和30天死亡率（2.7%对0.5%）也显著更高（p<0.001）。体重过轻（比值比[OR]，5.64；95%置信区间[CI]，2.47 - 12.92）和病态肥胖患者（OR，7.23；95% CI，3.01 - 17.39）的30天死亡几率显著更高。超重患者风险未增加，肥胖患者发病率略有增加（OR，1.54；95% CI，1.08 - 2.21），但30天死亡率无显著增加（p>0.05）。