A Critical Analysis of Perioperative Outcomes in Morbidly Obese Patients Following Renal Mass Surgery

Objective To evaluate if body mass index (BMI) ≥ 40 is associated with risk of postoperative complications, receipt of perioperative blood transfusion (PBT), length of hospital stay (LOS), perioperative death, or hospital readmission rate following renal mass surgery. Materials and Methods After Ins...

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Published in:Urology (Ridgewood, N.J.) N.J.), 2016-10, Vol.96, p.93-98
Main Authors: Grimes, Matthew D, Blute, Michael L, Wittmann, Tyler A, Mann, Michael A, Zorn, Kristin, Downs, Tracy M, Shi, Fangfang, Jarrard, David F, Best, Sara L, Richards, Kyle A, Nakada, Stephen Y, Abel, E. Jason
Format: Article
Language:English
Subjects:
Aged
Blood Transfusion - statistics & numerical data
Body Mass Index
Humans
Kidney Neoplasms - complications
Kidney Neoplasms - surgery
Length of Stay - statistics & numerical data
Middle Aged
Obesity, Morbid - complications
Patient Readmission - statistics & numerical data
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Retrospective Studies
Risk Assessment
Treatment Outcome
Urology
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Summary:Objective To evaluate if body mass index (BMI) ≥ 40 is associated with risk of postoperative complications, receipt of perioperative blood transfusion (PBT), length of hospital stay (LOS), perioperative death, or hospital readmission rate following renal mass surgery. Materials and Methods After Institutional Review Board approval, comprehensive information was collected for patients treated with surgery for renal mass from 2000 to 2015 at one institution. Univariable and multivariable analyses were used to evaluate the association of BMI ≥ 40 among other putative risk factors for perioperative outcomes. Results A total of 1048 patients were treated surgically, including 115 (11%) with BMI > 40. Minimally invasive and open surgical approaches were used for 480 (45.8%) and 568 (54.2%) patients, respectively. Morbid obesity was not associated with risk of major complications, overall complications, receipt of PBT, LOS, hospital readmission rate, or perioperative death. Charlson comorbidity index was the only independent predictor of major complications following renal mass surgery, P  = .0006, per point odds ratio 1.2 (95%C.I. 1.08-1.32). Surgical site infections (SSIs) were more common in patients with BMI ≥ 40 vs BMI 
ISSN:0090-4295
1527-9995
DOI:10.1016/j.urology.2016.06.018