High and low body mass index and 90-day postoperative outcomes in patients with Crohn's disease undergoing abdominal surgery.

OBJECTIVE

To evaluate the impact of high and low Body mass index (BMI) on 90-day postoperative outcomes in patients with Crohn's disease (CD).

METHODS

This retrospective cohort study (2017-2019) included 271 patients undergoing abdominal surgery, categorized as underweight (BMI <18.5), normal/overweight (18.5-30), and obese (>30). Primary outcomes were 90-day overall and severe (Clavien-Dindo >2) complications and total length of stay (LOS).

RESULTS

The cohort comprised 64 underweight, 189 normal/overweight, and 18 obese patients. Multivariable analysis revealed that underweight status was independently associated with higher overall complications (OR = 2.0, p = 0.045), severe complications (OR = 3.05, p = 0.018), and increased total LOS (beta = 3.43, p = 0.003). While obesity showed a trend toward higher morbidity in univariable analysis, it did not maintain independent significance after adjustment (p = 0.159).

CONCLUSION

Underweight status is a significant independent predictor of poor 90-day postoperative outcomes in patients with CD, necessitating targeted preoperative nutritional optimization.