When body mass index fails to measure up: perinephric and periumbilical fat as predictors of operative risk

Luke Martin; Gillian Seton; Booth Aldred; Paul Hopkins; Jessica Chan; Marta E. Heilbrun; Mary Mone; Courtney Scaife; William Peche

doi:10.1016/j.amjsurg.2016.09.001

When body mass index fails to measure up: perinephric and periumbilical fat as predictors of operative risk

Luke Martin, Gillian Seton, Booth Aldred, Paul Hopkins, Jessica Chan, Marta E. Heilbrun, Mary Mone, Courtney Scaife, William Peche

Research output: Contribution to journal › Article › peer-review

7 Scopus citations

Abstract

Background Obesity has been associated with worse outcomes and increased surgical technical difficulty. Perinephric fat (PNF) and periumbilical fat (PUF) are alternative metrics to body mass index. We hypothesized that PUF and PNF would offer improved prediction of perioperative risk. Methods 249 patients were retrospectively reviewed after elective, pelvic colorectal resections. PNF and PUF were collected using axial imaging. Operative risk measurements included estimated blood loss (EBL) and operative time (OT). Results In multivariate analyses of women, PUF and PNF were significant predictors of EBL; PNF was a significant predictor of OT. A 4.7-mm increase in PNF predicted a 15-minute increase in OT and 55-cc increase in EBL. An 8.6-mm increase in PUF predicted a 55-cc increase in EBL. In men, no metric was predictive. Conclusions In women, PNF and PUF may offer improved metrics for risk stratification, which can have important clinical and financial implications.

Original language	English (US)
Pages (from-to)	1039-1046
Number of pages	8
Journal	American journal of surgery
Volume	212
Issue number	6
DOIs	https://doi.org/10.1016/j.amjsurg.2016.09.001
State	Published - Dec 1 2016
Externally published	Yes

Bibliographical note

Funding Information:
This investigation was supported by the University of Utah Study Design and Biostatistics Center , with funding in part from the National Center for Research Resources and the National Center for Advancing Translational Sciences , National Institutes of Health , through grant 8UL1TR000105 (formerly UL1RR025764).

Publisher Copyright:
© 2016

Keywords

Body mass index
Colorectal surgery
Obesity
Perinephric fat
Perioperative risk assessment
Periumbilical fat

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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title = "When body mass index fails to measure up: perinephric and periumbilical fat as predictors of operative risk",

abstract = "Background Obesity has been associated with worse outcomes and increased surgical technical difficulty. Perinephric fat (PNF) and periumbilical fat (PUF) are alternative metrics to body mass index. We hypothesized that PUF and PNF would offer improved prediction of perioperative risk. Methods 249 patients were retrospectively reviewed after elective, pelvic colorectal resections. PNF and PUF were collected using axial imaging. Operative risk measurements included estimated blood loss (EBL) and operative time (OT). Results In multivariate analyses of women, PUF and PNF were significant predictors of EBL; PNF was a significant predictor of OT. A 4.7-mm increase in PNF predicted a 15-minute increase in OT and 55-cc increase in EBL. An 8.6-mm increase in PUF predicted a 55-cc increase in EBL. In men, no metric was predictive. Conclusions In women, PNF and PUF may offer improved metrics for risk stratification, which can have important clinical and financial implications.",

keywords = "Body mass index, Colorectal surgery, Obesity, Perinephric fat, Perioperative risk assessment, Periumbilical fat",

author = "Luke Martin and Gillian Seton and Booth Aldred and Paul Hopkins and Jessica Chan and Heilbrun, {Marta E.} and Mary Mone and Courtney Scaife and William Peche",

note = "Funding Information: This investigation was supported by the University of Utah Study Design and Biostatistics Center , with funding in part from the National Center for Research Resources and the National Center for Advancing Translational Sciences , National Institutes of Health , through grant 8UL1TR000105 (formerly UL1RR025764). Publisher Copyright: {\textcopyright} 2016",

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AU - Martin, Luke

AU - Seton, Gillian

AU - Aldred, Booth

AU - Hopkins, Paul

AU - Chan, Jessica

AU - Heilbrun, Marta E.

AU - Mone, Mary

AU - Scaife, Courtney

AU - Peche, William

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PY - 2016/12/1

Y1 - 2016/12/1

N2 - Background Obesity has been associated with worse outcomes and increased surgical technical difficulty. Perinephric fat (PNF) and periumbilical fat (PUF) are alternative metrics to body mass index. We hypothesized that PUF and PNF would offer improved prediction of perioperative risk. Methods 249 patients were retrospectively reviewed after elective, pelvic colorectal resections. PNF and PUF were collected using axial imaging. Operative risk measurements included estimated blood loss (EBL) and operative time (OT). Results In multivariate analyses of women, PUF and PNF were significant predictors of EBL; PNF was a significant predictor of OT. A 4.7-mm increase in PNF predicted a 15-minute increase in OT and 55-cc increase in EBL. An 8.6-mm increase in PUF predicted a 55-cc increase in EBL. In men, no metric was predictive. Conclusions In women, PNF and PUF may offer improved metrics for risk stratification, which can have important clinical and financial implications.

AB - Background Obesity has been associated with worse outcomes and increased surgical technical difficulty. Perinephric fat (PNF) and periumbilical fat (PUF) are alternative metrics to body mass index. We hypothesized that PUF and PNF would offer improved prediction of perioperative risk. Methods 249 patients were retrospectively reviewed after elective, pelvic colorectal resections. PNF and PUF were collected using axial imaging. Operative risk measurements included estimated blood loss (EBL) and operative time (OT). Results In multivariate analyses of women, PUF and PNF were significant predictors of EBL; PNF was a significant predictor of OT. A 4.7-mm increase in PNF predicted a 15-minute increase in OT and 55-cc increase in EBL. An 8.6-mm increase in PUF predicted a 55-cc increase in EBL. In men, no metric was predictive. Conclusions In women, PNF and PUF may offer improved metrics for risk stratification, which can have important clinical and financial implications.

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When body mass index fails to measure up: perinephric and periumbilical fat as predictors of operative risk

Abstract

Bibliographical note

Keywords

UN SDGs

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