HPB : the official journal of the International Hepato Pancreato Biliary Association · 2025
The impact of obesity on in-hospital outcome of patients who underwent hepatic resection surgeries; a US national-wide study.
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Esparham Ali, Shoar Saeed, Modukuru Venkat R, Agriantonis George, Whittington Jennifer, Shafaee Zahra
Аннотация
BACKGROUND: Previous studies have shown conflicting results on the effect of obesity on the outcome of liver resection. The current study investigates the impact of obesity in these patients.
METHODS: We included all the patients with hepatobiliary cancer who underwent liver resection between 2016 and 2020 using the International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS) codes. A propensity score matching analysis was performed to match obese and non-obese groups.
RESULTS: A total of 8,731 patients were included in the study. The trend of obesity increased significantly from 14.6% in 2016 to 19.0% in 2020. After PSM, obesity was independently associated with increased odds of mechanical ventilation (OR: 1.82, 95% CI: 1.30-2.56, p-value<0.001), acute kidney injury (OR: 1.31, 95% CI: 1.04-1.65, p-value=0.023), and vasopressor need (OR: 2.11, 95% CI: 1.32-3.38, p-value=0.002). However, rates of blood transfusion, surgical site infection, pneumonia, sepsis, postoperative delirium, bowel obstruction, cardiac arrest, deep vein thrombosis/pulmonary thromboembolism, ileus, nausea and vomiting, postoperative anemia, post-procedural shock, and in-hospital mortality did not differ significantly between groups. The hospitalization costs were higher in the obese group ($28,272 [19,516-40,842] vs. $26,402 [18,099-37,810], p-value<0.001, respectively).
CONCLUSION: Obesity is linked to higher postoperative complications and hospitalization costs after hepatectomy.
METHODS: We included all the patients with hepatobiliary cancer who underwent liver resection between 2016 and 2020 using the International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS) codes. A propensity score matching analysis was performed to match obese and non-obese groups.
RESULTS: A total of 8,731 patients were included in the study. The trend of obesity increased significantly from 14.6% in 2016 to 19.0% in 2020. After PSM, obesity was independently associated with increased odds of mechanical ventilation (OR: 1.82, 95% CI: 1.30-2.56, p-value<0.001), acute kidney injury (OR: 1.31, 95% CI: 1.04-1.65, p-value=0.023), and vasopressor need (OR: 2.11, 95% CI: 1.32-3.38, p-value=0.002). However, rates of blood transfusion, surgical site infection, pneumonia, sepsis, postoperative delirium, bowel obstruction, cardiac arrest, deep vein thrombosis/pulmonary thromboembolism, ileus, nausea and vomiting, postoperative anemia, post-procedural shock, and in-hospital mortality did not differ significantly between groups. The hospitalization costs were higher in the obese group ($28,272 [19,516-40,842] vs. $26,402 [18,099-37,810], p-value<0.001, respectively).
CONCLUSION: Obesity is linked to higher postoperative complications and hospitalization costs after hepatectomy.