Obesity Does Not Impact Perioperative or Postoperative Outcomes in Patients with Inflammatory Bowel Disease

• Published in: Journal of gastrointestinal surgery Vol. 20; no. 4; pp. 725 - 733
• Main Authors: Guardado, Jesse, Carchman, Evie, Danicic, Ashley E., Salgado, Javier, Watson, Andrew R., Celebrezze, James P., Medich, David S., Holder-Murray, Jennifer
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-04-2016; Springer Nature B.V
• Subjects: Adult; Body Mass Index; Female; Gastroenterology; Humans; Ideal Body Weight; Inflammatory bowel disease; Inflammatory Bowel Diseases - surgery; Intraoperative Complications; Male; Medicine; Medicine & Public Health; Middle Aged; Obesity - complications; Operative Time; Original Article; Overweight - complications; Postoperative Complications; Postoperative Period; Retrospective Studies; Surgery; Thinness - complications; Inflammatory bowel disease; Perioperative outcomes; Obesity; Laparoscopic colectomy; Ulcerative colitis; Crohn’s disease
• ISSN: 1091-255X; 1873-4626
• DOI: 10.1007/s11605-015-3060-4

Background
While the prevalence of obesity in IBD patients is rapidly increasing, it is unclear if obesity impacts surgical outcomes in this population. We aim to investigate the effects of BMI on perioperative and postoperative outcomes in IBD patients by stratifying patients into BMI groups and comparing outcomes between these groups.
Methods
This is a retrospective cohort study where IBD patients who underwent intestinal surgeries between the years of 2000 to 2014 were identified. The patients were divided into groups based on BMI: underweight (BMI <18.5), normal weight (BMI 18.5–24.9), overweight (BMI 25–29.9), and obese (BMI ≥30). Preoperative patient demographics, operative variables, and postoperative complications were collected and compared between BMI groups.
Results
A total of 391 surgeries were reviewed (34 underweight, 187 normal weight, 105 overweight, and 65 obese) from 325 patients. No differences were observed in preoperative patient demographics, type of IBD, preoperative steroid or biologic mediator use, or mean laboratory values. No differences were observed in percent operative procedures with anastomosis, surgeries converted to open, estimated blood loss, intraoperative complications, and median operative time. Thirty-day postoperative complication rates including total complications, wound infection, or anastomotic leak were similar between groups. There was a statistically significant increased postoperative bleeding risk (
p
 = 0.029) in underweight patients. The relative percent for increased postoperative bleeding risk between BMI groups was as follows: 2.9 % in underweight, zero in normal weight, 2.9 % in overweight, and zero in obese.
Conclusion
Obesity does not appear to impact intraoperative variables nor does obesity appear to worsen postoperative complication rates in IBD patients.