Morbid obesity is an independent risk factor for postoperative renal dysfunction in young adults: a review of the American College of Surgeons National Surgical Quality Improvement Program database

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• 作者：Cedrina L. Calder ; M.D.^a ; Gezzer Ortega ; M.D. ; M.P.H.^a ; Amit Vij ; B.S.^b ; Karan Chawla ; B.S.^b ; Chioma Nnamdi-Emetarom ; B.S.^b ; Stephanie Stephanie ; B.S.^b ; Clive O. Callender ; M.D.^a ; Terrence M. Fullum ; M.D.^a ; ^{tfullum@howard.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Morbid obesity ; Renal complications ; Renal failure ; ACS NSQIP
• 刊名：The American Journal of Surgery
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：211
• 期：4
• 页码：772-777
• 全文大小：555 K

文摘

Little information exists on the acute effects of elective surgery on renal function. Our aim was to determine if obesity was an independent risk factor for postoperative renal complications (RCs).

Methods

A total of 119,142 patients aged 18 to 35 years with body mass index (BMI) ≥18 kg/m² obtained from American College of Surgeons National Surgical Quality Improvement Project (2005 to 2010) were classified into standard BMI categories. Association between BMI and preoperative estimated glomerular filtration rate (eGFR; calculated using modification of diet in renal disease formula) was analyzed. Postoperative changes in eGFR and RCs were measured. Multivariate regression analysis was performed adjusting for all variables.

Results

Postoperatively, there was a reduction in eGFR among the overweight (−3.4 mL/min/1.73 m², P < .001), obese class I (−3.9 mL/min/1.73 m², P = .001), and obese class II (−5.3 mL/min/1.73 m², P < .001). The odds of any postoperative RC was significantly higher in obese class III patients (odds ratio = 2.01 95% confidence interval 1.07 to 3.76, P = .029).

Conclusions

Results seen in patients with BMI greater than 40 indicate that BMI can serve as an independent predictor of RCs.