New Measures, Old Conclusions: Obesity Does Not Worsen Outcomes after Elective Abdominal Aortic Aneurysm Repair

AORTA

article

Katie F. Boag¹  Mohammed A. Waduud²  Keleabetswe Pabale²  Benjamin Wood¹  Marc Bailey²  Julian A. Scott²  Joshua John Sommerville Wall² 

[1] Leeds Teaching Hospitals NHS Trust, St James' University Hospital;Leeds Vascular Institute;Faculty of Medicine and Health, University of Leeds

关键词: abdominal aortic aneurysm;    AAA;    obesity;    mortality;    elective;   

DOI  :  10.1055/s-0042-1742699

来源: Thieme

【 摘 要 】

Background The “obesity paradox,” whereby the body mass index (BMI) mortality curve is “U-shaped,” is a well-studied phenomenon in vascular surgery. However, there has been an overreliance on BMI as the measure of obesity, which has shown to poorly correlate with clinical outcomes. Robust measures such as waist-hip ratio (WHR) have been suggested as a more accurate marker reflecting central obesity.Objectives The objectives of this study were to evaluate the correlation between BMI and WHR on postoperative morbidity and mortality after elective abdominal aortic aneurysm (AAA) repair.Methods Data were collected from the Leeds Vascular Institute between January 2006 and December 2016. The primary outcome was mortality and secondary outcomes included length of stay (LOS) and all-cause readmission. Binary logistic regression, linear regression, and correlation analysis were used to identify associations between BMI and WHR in relation to outcome measures.Results After exclusions, 432 elective AAA repairs (281 open surgical repair [OSR] and 151 endovascular aneurysm repairs [EVARs]) were identified to be eligible for the study. The combined 30-day and 4-year mortality was 1.2 and 20.1%, respectively. The 30-day readmission rate was 3.9% and the average LOS was 7.33 (standard deviation 18.5) days. BMI data was recorded for 275 patients (63.7%) and WHR for 355 patients (82.2%). Logistic regression analysis highlighted no association between BMI and WHR with mortality, readmission, or LOS following OSR or EVAR.Conclusion The results of this study suggest patients should not be denied treatment for AAA based on obesity alone.

【 授权许可】

Unknown