New research shows that obesity is associated with an increased risk of complications following surgery, including infection, blood clots and kidney complications.
Researchers claim the study highlights the need for broader public health interventions and that obese patients require careful management for these complications.
Using data drawn from the National Surgical Quality Improvement Programme, Robert Meguid and co-researchers studied an initial data set representing more than 5.5 million patients, 44.6% of whom had obesity.
They focused on nine surgical specialties, including general, thoracic and vascular, comparing pre-operative characteristics and post-operative outcomes within body mass index (BMI) classes.
They found that compared to patients of average weight, patients who had overweight or obesity had higher risk-adjusted odds of developing infection, kidney failure and venous thromboembolism, or blood clots in the veins, following surgery.
Patients in the obesity class III category, with a BMI of 40kg/m² or more also had an elevated risk of unplanned hospital readmission.
He said: ‘When we began the research, we did think that increased risk would be the case. Though we did think we might see an increased risk for other post-operative complications beyond infection, kidney failure, and thromboembolism in both overweight and each class of obesity, that wasn't what we saw.’
In his surgical practice, he has observed that extra intra-abdominal fat tissue can lengthen the duration of surgery and make them more complicated. The data he and his colleagues analysed showed that surgery times were six minutes longer for patients with obesity.
Overweight and obesity can be a factor in immediate recovery from surgery.
He added: ‘With lung surgery in particular, ambulating after surgery is a critical part of recovery. It can improve a patient's spirit, decreases the risk of pneumonia, it can improve comfort and decrease the risk of blood clots forming and it can help the bowels wake up. It's so important that patients can be up and walking after surgery, but it can be especially challenging when obesity is a factor.
‘We need to be straightforward in talking about the body, and we need to be honest with our patients. With overweight and obesity being so prevalent in our society, this is not an issue that's going to be solved by one surgeon or one institution. It's a public health issue that we need to be addressing at every level – local, state and national.’
Earlier this month, another study found that a BMI in the range considered overweight is not necessarily associated with a higher risk of death.
The researchers say their work adds to a growing body of evidence to suggest that BMI alone is not an accurate indicator of overall health.
