Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Anesthesiology and Pain Medicine, College of Medicine, Seoul National University, Seoul, Korea.
J Korean Med Sci. 2023 Oct 16;38(40):e310. doi: 10.3346/jkms.2023.38.e310.
Body mass index (BMI) and waist circumference (WC) were used to evaluate nutritional status and obesity. We aimed to examine whether preoperative BMI or WC was associated with mortality after cancer surgery.
This population-based cohort study used data extracted from the National Health Insurance Service database of South Korea. We included adult patients who underwent major cancer surgery with curative intent between January 1, 2016, and December 31, 2020.
A total of 87,220 patients were included in the final analysis, and 1,374 (1.6%) died within 90 days after cancer surgery. In the multiple logistic regression model, the BMI < 18.5/kg/m² and > 35 kg/m² groups showed 1.98-fold (odds ratio [OR], 1.98; 95% confidence interval [CI], 1.58-2.49; < 0.001) and 2.60-fold (OR, 2.60; 95% CI, 1.25-5.40; < 0.001) higher 90-day mortality after cancer surgery than did the BMI 18.5-24.9 kg/m² group. The 25.0-29.9 kg/m² ( = 0.144) and 30.0-34.9 kg/m² ( = 0.105) BMI groups did not show significant differences compared to the BMI 18.5-24.9 kg/m² group. Compared with the normal WC group, the high ( = 0.052) and very high ( = 0.232) WC groups also did not show significant differences in terms of 90-day mortality.
Preoperative BMI < 18.5 kg/m² and > 35 kg/m² is associated with an elevated risk of 90-day mortality after major cancer surgery. However, preoperative WC was not significantly associated with 90-day mortality after cancer surgery.
体重指数（BMI）和腰围（WC）用于评估营养状况和肥胖。我们旨在研究术前 BMI 或 WC 是否与癌症手术后的死亡率相关。
本基于人群的队列研究使用了从韩国国民健康保险服务数据库中提取的数据。我们纳入了 2016 年 1 月 1 日至 2020 年 12 月 31 日期间接受根治性癌症手术的成年患者。
共有 87220 名患者纳入最终分析，87220 名患者中有 1374 名（1.6%）在癌症手术后 90 天内死亡。在多因素逻辑回归模型中，BMI<18.5/kg/m² 和>35 kg/m² 组的 90 天死亡率分别为 BMI 18.5-24.9 kg/m² 组的 1.98 倍（比值比[OR]，1.98；95%置信区间[CI]，1.58-2.49；<0.001）和 2.60 倍（OR，2.60；95% CI，1.25-5.40；<0.001）。BMI 为 25.0-29.9 kg/m²（ = 0.144）和 30.0-34.9 kg/m²（ = 0.105）的组与 BMI 18.5-24.9 kg/m² 组相比，差异无统计学意义。与正常 WC 组相比，高（ = 0.052）和非常高（ = 0.232）WC 组的 90 天死亡率差异也无统计学意义。
术前 BMI<18.5 kg/m² 和>35 kg/m² 与主要癌症手术后 90 天内死亡风险升高相关。然而，术前 WC 与癌症手术后 90 天内的死亡率无显著相关性。
