Patients with class III obesity are at elevated risk of postoperative morbidity after surgery for left-sided diverticular disease: a retrospective population-level study.
Journal Articles
Overview
Research
Identity
Additional Document Info
View All
Overview
abstract
BACKGROUND: Although obesity is a well-established risk factor for the development of diverticular disease, studies focusing on the effect of body mass index (BMI) on postoperative outcomes require updating. This population-level retrospective cohort study was designed to evaluate the effect of BMI on postoperative outcomes after operative intervention for left-sided diverticular disease. METHODS: This was a population-based retrospective cohort study using the Healthcare Cost and Utilization Project National Inpatient Sample (NIS) (September 1, 2015 to December 31, 2019). The International Classification of Diseases, 10th Revision, Clinical Modification codes were used to identify a cohort of adult patients with a primary admission diagnosis of diverticulitis. Patients were stratified according to obesity status (ie, not obese: BMI of <30.0 kg/m2; class I obesity: BMI of 30.0-34.9 kg/m2; class II obesity: BMI of 35.0-39.9 kg/m2; class III obesity: BMI of >40.0 kg/m2). The primary outcome was overall in-hospital postoperative morbidity. The multivariate regression models were fit. RESULTS: There were 33,029 patients identified in the NIS who underwent left-sided colonic resection for diverticular disease. There were 27,212 patients who were not obese, 2209 patients with class I obesity, 1710 patients with class II obesity, and 1898 patients with class III obesity. Patients with class III obesity (ie, a BMI of >40.0 kg/m2) had 72.7% higher odds (95% CI, 1.54-1.94) of experiencing in-hospital postoperative morbidity than patients with a BMI of <30.0 kg/m2. Patients with class III obesity had 26.9% higher odds (95% CI, 0.98-1.65) of experiencing in-hospital postoperative infection, 54.6% higher odds (95% CI, 1.35-1.77) of experiencing in-hospital postoperative gastrointestinal complications, and 70.9% higher odds (95% CI, 1.48-1.97) of experiencing in-hospital postoperative genitourinary complications than those with a BMI of <30.0 kg/m2. CONCLUSION: Patients with class III obesity undergoing operative intervention for colonic diverticular disease are at increased risk of short-term postoperative morbidity compared with those with a BMI of <30.0 kg/m2.
