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The Impact of Obesity on the 30-day Morbidity and Mortality After Surgery for Ovarian Cancer
  1. Haider Mahdi, MD*,
  2. Ahmed A. Alhassani, MD,
  3. David Lockhart, BS,
  4. Hussain Al-Fatlawi, MD§ and
  5. Andrew Wiechert, MD*
  1. *Gynecologic Oncology Division, Obstetrics and Gynecology and Women’s Health Institute, Cleveland Clinic, Cleveland, OH;
  2. Red Crescent Clinic of Tampa Bay, Tampa, FL;
  3. Department of Biostatistics, University of Washington, Seattle, WA; and
  4. §University of Kufa School of Medicine, Najaf, Iraq.
  1. Address correspondence and reprint requests to Haider Mahdi, Obstetrics and Gynecology and Women’s Health Institute, 9500 Euclid Ave, Cleveland, OH 44195. E-mail: mahdih@ccf.org.

Abstract

Objectives To examine the effect of body mass index (BMI) on postoperative 30-day morbidity and mortality after surgery for ovarian cancer (OC).

Methods Patients with OC were identified from the American College of Surgeons National Surgical Quality Improvement Program from 2005 to 2011. Women were divided into 3 groups: nonobese (BMI <30 kg/m2), obese (30 to <40 kg/m2), and morbidly obese (≥40 kg/m2). Multivariable logistic regression models were performed.

Results Of 2061 women included in this study, 1336 (65%) were nonobese, 560 (27%) were obese, and 165 (8%) were morbidly obese. The overall 30-day mortality and morbidity rates for the entire cohort were 2% and 31%, respectively. In multivariate analyses adjusting for confounders, both obese (odds ratio [OR], 0.9; 95% confidence interval [CI], 0.4–2.0; P = 0.87) and morbid obesity (OR, 0.8; 95% CI, 0.1–3.0; P = 0.73) were not significant predictors of increased 30-day postoperative mortality. Likewise, rates of any complication in 30 days were comparable between nonobese, obese, and morbidly obese patients (31% vs. 28% vs. 33%, respectively; P = 0.35) with no significant difference even after adjusting for other confounders (OR, 0.9; 95% CI, 0.7–1.1; P = 0.26 and OR, 1.1; 95% CI, 0.7–1.6; P = 0.70, respectively). Obese and morbidly obese patients were more likely to have diabetes, hypertension requiring medications, cardiac morbidities, higher American Society of Anesthesiologists class, and leukocytosis and less likely to have weight loss before surgery.

Conclusions With appropriate control for confounding comorbidities, the 30-day morbidity and mortality rates for the obese and morbidly obese patients undergoing surgery for OC do not seem to differ. Therefore, reported inferior long-term survival for these patients is likely related to a different phase of their disease and treatment process and is deserving of further investigation.

  • Obesity
  • Morbid obesity
  • Surgery
  • Ovarian cancer
  • Morbidity
  • Mortality

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Footnotes

  • The authors declare no conflicts of interest.

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