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Low BMI associated with higher short-term risk for death after surgery

Turrentine FE. Arch Surg. 2011;doi:10.1001/archsurg.2011.310.

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Patients with BMIs lower than 23.1 had a 40% higher risk for death within 30 days after surgery vs. those with BMIs in the middle range, according to recent data.

"Recent reports suggest that the prevalence of obesity among US adults has increased more than 100% since 1990," researchers from the University of Virginia in Charlottesville wrote.

"This analysis examines the relationship between obesity and surgical mortality."

The researchers collected information from the American College of Surgeons National Surgical Quality Improvement Program database on 30-day mortality among patients who underwent a major surgical procedure. They included data from 189,533 cases of general and vascular surgical procedures that were reported in 2005 and 2006.

Of those included in the analysis, 3,245 patients died within 30 days of surgery, according to the researchers. Among patients with BMIs of 23.1 or lower, they said the percentage of deaths was more than twofold higher vs. the percentage of deaths among patients with a BMI of 35.3 or higher. Furthermore, mortality risk was 40% higher in this population vs. those with BMIs between 26.3 and 29.7 (OR=1.4; 95% CI, 1.25-1.58).

The association between BMI and risk for death also varied with the type of procedure (P<.05). Using laparoscopy as the selected reference population, the effect of BMI on mortality risk was significantly different among patients who underwent colostomy, wound debridement, ileostomy, colorectal resection, musculoskeletal system procedures, endarterectomy of head and neck vasculature, upper gastrointestinal procedures, cholecystectomy, hernia repair and mastectomy.

"These results indicate that BMI is a significant predictor of mortality within 30 days of surgery, even after adjusting for the contribution to mortality risk made by type of surgery and for a specific patient's overall expected risk of death," the researchers wrote.

Disclosure: The researchers report no relevant financial disclosures.

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