TY - JOUR
T1 - Mortality in open abdominal aortic surgery in patients with morbid obesity
AU - Khorgami, Zhamak
AU - Sclabas, Guido M.
AU - Aminian, Ali
AU - Lau, Peter J.
AU - Chow, Geoffrey S.
AU - Malgor, Rafael D.
AU - Howard, C. Anthony
AU - Taubman, Kevin E.
N1 - Publisher Copyright:
© 2019 American Society for Bariatric Surgery
PY - 2019/6
Y1 - 2019/6
N2 - Background: Open abdominal aortic surgery is among procedures with high morbidity and mortality. Adverse postoperative complications may be more common in morbidly obese patients. Objectives: This study compared the outcomes of open abdominal aortic surgeries in patients with and without morbid obesity. Setting: A retrospective analysis of 2007–2014 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample. Methods: We included patients who underwent open abdominal aortic aneurysm (AAA) repair or open aorta-iliac-femoral (AIF) bypass. Demographic factors, morbid obesity, co-morbidities, and emergent versus elective surgery were considered for univariate and multivariate analyses. Results: A total of 29,340 patients (13,443 AAA repair and 15,897 AIF bypass) were included (age 66.3 ± 10.8 years, 65.7% male). The mortality was 9.1% in 536 patients with morbid obesity compared with 7.1% in patients without morbid obesity. Based on multivariate analysis, age, existing co-morbidities, emergent versus elective setting, and morbid obesity were found to be independent predictors of mortality. Patients with morbid obesity had an odds ratio of 3.61 (95% CI, 1.50–8.68; P =.004) for mortality, longer mean length of stay (11.2 versus 9.3 days, P <.001), and higher total hospital charges ($99,500 versus $73,700, P <.001). Conclusions: Morbid obesity is an independent risk factor of mortality in patients undergoing open AAA repair and AIF bypass. Weight loss strategies should be considered for morbidly obese patients with an anticipation of open abdominal aortic procedures.
AB - Background: Open abdominal aortic surgery is among procedures with high morbidity and mortality. Adverse postoperative complications may be more common in morbidly obese patients. Objectives: This study compared the outcomes of open abdominal aortic surgeries in patients with and without morbid obesity. Setting: A retrospective analysis of 2007–2014 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample. Methods: We included patients who underwent open abdominal aortic aneurysm (AAA) repair or open aorta-iliac-femoral (AIF) bypass. Demographic factors, morbid obesity, co-morbidities, and emergent versus elective surgery were considered for univariate and multivariate analyses. Results: A total of 29,340 patients (13,443 AAA repair and 15,897 AIF bypass) were included (age 66.3 ± 10.8 years, 65.7% male). The mortality was 9.1% in 536 patients with morbid obesity compared with 7.1% in patients without morbid obesity. Based on multivariate analysis, age, existing co-morbidities, emergent versus elective setting, and morbid obesity were found to be independent predictors of mortality. Patients with morbid obesity had an odds ratio of 3.61 (95% CI, 1.50–8.68; P =.004) for mortality, longer mean length of stay (11.2 versus 9.3 days, P <.001), and higher total hospital charges ($99,500 versus $73,700, P <.001). Conclusions: Morbid obesity is an independent risk factor of mortality in patients undergoing open AAA repair and AIF bypass. Weight loss strategies should be considered for morbidly obese patients with an anticipation of open abdominal aortic procedures.
KW - Abdominal aortic aneurysm
KW - Aortobifemoral bypass
KW - Bariatric surgery
KW - Morbid obesity
KW - Mortality
KW - Weight loss
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U2 - 10.1016/j.soard.2019.03.044
DO - 10.1016/j.soard.2019.03.044
M3 - Article
C2 - 31097382
AN - SCOPUS:85065546667
SN - 1550-7289
VL - 15
SP - 958
EP - 963
JO - Surgery for Obesity and Related Diseases
JF - Surgery for Obesity and Related Diseases
IS - 6
ER -