Impact of preoperative body mass index and weight loss on morbidity and mortality following colorectal cancer—a retrospective cohort study
Purpose Body weight and preoperative weight loss (WL) are controversially discussed as risk factors for postoperative morbidity and mortality in colorectal cancer surgery. The objective of this study is to determine whether body mass index (BMI) or WL is associated with a higher postoperative compli...
Gespeichert in:
| Veröffentlicht in: | International journal of colorectal disease 2022-09, Vol.37 (9), p.1983-1995 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1995 |
|---|---|
| container_issue | 9 |
| container_start_page | 1983 |
| container_title | International journal of colorectal disease |
| container_volume | 37 |
| creator | Axt, Steffen Wilhelm, Peter Spahlinger, Ricarda Rolinger, Jens Johannink, Jonas Axt, Lena Kirschniak, Andreas Falch, Claudius |
| description | Purpose
Body weight and preoperative weight loss (WL) are controversially discussed as risk factors for postoperative morbidity and mortality in colorectal cancer surgery. The objective of this study is to determine whether body mass index (BMI) or WL is associated with a higher postoperative complication rate.
Methods
In this retrospective cohort study, data analysis of 1241 consecutive patients undergoing colorectal cancer surgery in an 11-year period was performed. The main outcome measures were wound infections (WI), anastomotic leakages (AL), and in-house mortality.
Results
A total of 697 (56%) patients with colon and 544 (44%) with rectum carcinoma underwent surgery. The rate of WI for each location increased with rising BMI. The threshold value was 28.8 kg/m
2
. Obese patients developed significantly more WI than normal-weight patients did following rectal resection (18.0% vs. 8.2%,
p
= 0.018). Patients with preoperative WL developed significantly more AL following colon resections than did patients without preoperative WL (6.2% vs. 2.5%,
p
= 0.046). In-house mortality was significantly higher in obese patients following colon resections than in overweight patients (4.3% vs. 0.4%,
p
= 0.012). Regression analysis with reference to postoperative in-house mortality revealed neither increased BMI nor WL as an independent risk factor.
Conclusions
Increased preoperative BMI is associated with a higher WI rate. AL rate after colon resection was significantly higher in patients showing preoperative WL. Preoperative BMI and WL are therefore risk factors for postoperative morbidity in this study. Nevertheless, this has to be further clarified by means of prospective studies.
Trial registration
DRKS00025359, 21.05.2021, retrospectively registered. |
| doi_str_mv | 10.1007/s00384-022-04228-1 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9436834</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A715923373</galeid><sourcerecordid>A715923373</sourcerecordid><originalsourceid>FETCH-LOGICAL-c471t-9b5b7a157c8a5364a0f23c1f6e19608053218507f6f4ba86cade88a744ebacc23</originalsourceid><addsrcrecordid>eNp9Ustu1TAQjRCIlsIPsECW2HST4ldiZ4NUVTwqVWIDa2viTO51ldjBzm17d3xAl3whX4LTW_pAiI3tmTnnjGd0iuI1o0eMUvUuUSq0LCnnJZWc65I9KfaZFLxkvOZPH7z3ihcpnVPKVK3k82JPVI3Uda33i-vTcQI7k9CTKWKYMMLsLpC0oduSEVIiznd4RcB35BLdaj2TIeRs8GQMsXWdm7c3xRzNMCxRH4YhXDq_IjYMIaLNeWLBW4y_fvwEEnGOIU05vzSyYZ2ZJM2bbvuyeNbDkPDV7X1QfPv44evJ5_Lsy6fTk-Oz0krF5rJpq1YBq5TVUIlaAu25sKyvkTU11bQSnOmKqr7uZQu6ttCh1qCkxBas5eKgeL_TnTbtiJ1FP0cYzBTdCHFrAjjzuOLd2qzChWmkqLWQWeDwViCG7xtMsxldsjgM4DFskuGKMqryufR6-xf0PGyiz-MtqIZKqSW7R61gQON8H3Jfu4iaY8WqhguhREYd_QMFy3yjs8Fj73L-EYHvCDZvPEXs72Zk1CweMjsPmewhc-Mhs_zlzcPt3FH-mCYDxA6QcsmvMN6P9B_Z358M1TY</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2709044841</pqid></control><display><type>article</type><title>Impact of preoperative body mass index and weight loss on morbidity and mortality following colorectal cancer—a retrospective cohort study</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Axt, Steffen ; Wilhelm, Peter ; Spahlinger, Ricarda ; Rolinger, Jens ; Johannink, Jonas ; Axt, Lena ; Kirschniak, Andreas ; Falch, Claudius</creator><creatorcontrib>Axt, Steffen ; Wilhelm, Peter ; Spahlinger, Ricarda ; Rolinger, Jens ; Johannink, Jonas ; Axt, Lena ; Kirschniak, Andreas ; Falch, Claudius</creatorcontrib><description>Purpose
Body weight and preoperative weight loss (WL) are controversially discussed as risk factors for postoperative morbidity and mortality in colorectal cancer surgery. The objective of this study is to determine whether body mass index (BMI) or WL is associated with a higher postoperative complication rate.
Methods
In this retrospective cohort study, data analysis of 1241 consecutive patients undergoing colorectal cancer surgery in an 11-year period was performed. The main outcome measures were wound infections (WI), anastomotic leakages (AL), and in-house mortality.
Results
A total of 697 (56%) patients with colon and 544 (44%) with rectum carcinoma underwent surgery. The rate of WI for each location increased with rising BMI. The threshold value was 28.8 kg/m
2
. Obese patients developed significantly more WI than normal-weight patients did following rectal resection (18.0% vs. 8.2%,
p
= 0.018). Patients with preoperative WL developed significantly more AL following colon resections than did patients without preoperative WL (6.2% vs. 2.5%,
p
= 0.046). In-house mortality was significantly higher in obese patients following colon resections than in overweight patients (4.3% vs. 0.4%,
p
= 0.012). Regression analysis with reference to postoperative in-house mortality revealed neither increased BMI nor WL as an independent risk factor.
Conclusions
Increased preoperative BMI is associated with a higher WI rate. AL rate after colon resection was significantly higher in patients showing preoperative WL. Preoperative BMI and WL are therefore risk factors for postoperative morbidity in this study. Nevertheless, this has to be further clarified by means of prospective studies.
Trial registration
DRKS00025359, 21.05.2021, retrospectively registered.</description><identifier>ISSN: 1432-1262</identifier><identifier>ISSN: 0179-1958</identifier><identifier>EISSN: 1432-1262</identifier><identifier>DOI: 10.1007/s00384-022-04228-1</identifier><identifier>PMID: 35948668</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Analysis ; Anastomotic Leak ; Body Mass Index ; Body weight ; Body weight loss ; Cancer ; Cancer surgery ; Cohort analysis ; Colorectal cancer ; Colorectal carcinoma ; Complications ; Gastroenterology ; Hepatology ; Humans ; Information management ; Internal Medicine ; Medicine ; Medicine & Public Health ; Morbidity ; Mortality ; Obesity - complications ; Oncology, Experimental ; Overweight ; Patient outcomes ; Patients ; Postoperative ; Proctology ; Prospective Studies ; Rectal Neoplasms - surgery ; Retrospective Studies ; Risk factors ; Surgery ; Weight Loss</subject><ispartof>International journal of colorectal disease, 2022-09, Vol.37 (9), p.1983-1995</ispartof><rights>The Author(s) 2022</rights><rights>2022. The Author(s).</rights><rights>COPYRIGHT 2022 Springer</rights><rights>The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c471t-9b5b7a157c8a5364a0f23c1f6e19608053218507f6f4ba86cade88a744ebacc23</citedby><cites>FETCH-LOGICAL-c471t-9b5b7a157c8a5364a0f23c1f6e19608053218507f6f4ba86cade88a744ebacc23</cites><orcidid>0000-0002-6809-2840</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00384-022-04228-1$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00384-022-04228-1$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,777,781,882,27905,27906,41469,42538,51300</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35948668$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Axt, Steffen</creatorcontrib><creatorcontrib>Wilhelm, Peter</creatorcontrib><creatorcontrib>Spahlinger, Ricarda</creatorcontrib><creatorcontrib>Rolinger, Jens</creatorcontrib><creatorcontrib>Johannink, Jonas</creatorcontrib><creatorcontrib>Axt, Lena</creatorcontrib><creatorcontrib>Kirschniak, Andreas</creatorcontrib><creatorcontrib>Falch, Claudius</creatorcontrib><title>Impact of preoperative body mass index and weight loss on morbidity and mortality following colorectal cancer—a retrospective cohort study</title><title>International journal of colorectal disease</title><addtitle>Int J Colorectal Dis</addtitle><addtitle>Int J Colorectal Dis</addtitle><description>Purpose
Body weight and preoperative weight loss (WL) are controversially discussed as risk factors for postoperative morbidity and mortality in colorectal cancer surgery. The objective of this study is to determine whether body mass index (BMI) or WL is associated with a higher postoperative complication rate.
Methods
In this retrospective cohort study, data analysis of 1241 consecutive patients undergoing colorectal cancer surgery in an 11-year period was performed. The main outcome measures were wound infections (WI), anastomotic leakages (AL), and in-house mortality.
Results
A total of 697 (56%) patients with colon and 544 (44%) with rectum carcinoma underwent surgery. The rate of WI for each location increased with rising BMI. The threshold value was 28.8 kg/m
2
. Obese patients developed significantly more WI than normal-weight patients did following rectal resection (18.0% vs. 8.2%,
p
= 0.018). Patients with preoperative WL developed significantly more AL following colon resections than did patients without preoperative WL (6.2% vs. 2.5%,
p
= 0.046). In-house mortality was significantly higher in obese patients following colon resections than in overweight patients (4.3% vs. 0.4%,
p
= 0.012). Regression analysis with reference to postoperative in-house mortality revealed neither increased BMI nor WL as an independent risk factor.
Conclusions
Increased preoperative BMI is associated with a higher WI rate. AL rate after colon resection was significantly higher in patients showing preoperative WL. Preoperative BMI and WL are therefore risk factors for postoperative morbidity in this study. Nevertheless, this has to be further clarified by means of prospective studies.
Trial registration
DRKS00025359, 21.05.2021, retrospectively registered.</description><subject>Analysis</subject><subject>Anastomotic Leak</subject><subject>Body Mass Index</subject><subject>Body weight</subject><subject>Body weight loss</subject><subject>Cancer</subject><subject>Cancer surgery</subject><subject>Cohort analysis</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Complications</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Information management</subject><subject>Internal Medicine</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Obesity - complications</subject><subject>Oncology, Experimental</subject><subject>Overweight</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Postoperative</subject><subject>Proctology</subject><subject>Prospective Studies</subject><subject>Rectal Neoplasms - surgery</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>Surgery</subject><subject>Weight Loss</subject><issn>1432-1262</issn><issn>0179-1958</issn><issn>1432-1262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9Ustu1TAQjRCIlsIPsECW2HST4ldiZ4NUVTwqVWIDa2viTO51ldjBzm17d3xAl3whX4LTW_pAiI3tmTnnjGd0iuI1o0eMUvUuUSq0LCnnJZWc65I9KfaZFLxkvOZPH7z3ihcpnVPKVK3k82JPVI3Uda33i-vTcQI7k9CTKWKYMMLsLpC0oduSEVIiznd4RcB35BLdaj2TIeRs8GQMsXWdm7c3xRzNMCxRH4YhXDq_IjYMIaLNeWLBW4y_fvwEEnGOIU05vzSyYZ2ZJM2bbvuyeNbDkPDV7X1QfPv44evJ5_Lsy6fTk-Oz0krF5rJpq1YBq5TVUIlaAu25sKyvkTU11bQSnOmKqr7uZQu6ttCh1qCkxBas5eKgeL_TnTbtiJ1FP0cYzBTdCHFrAjjzuOLd2qzChWmkqLWQWeDwViCG7xtMsxldsjgM4DFskuGKMqryufR6-xf0PGyiz-MtqIZKqSW7R61gQON8H3Jfu4iaY8WqhguhREYd_QMFy3yjs8Fj73L-EYHvCDZvPEXs72Zk1CweMjsPmewhc-Mhs_zlzcPt3FH-mCYDxA6QcsmvMN6P9B_Z358M1TY</recordid><startdate>20220901</startdate><enddate>20220901</enddate><creator>Axt, Steffen</creator><creator>Wilhelm, Peter</creator><creator>Spahlinger, Ricarda</creator><creator>Rolinger, Jens</creator><creator>Johannink, Jonas</creator><creator>Axt, Lena</creator><creator>Kirschniak, Andreas</creator><creator>Falch, Claudius</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-6809-2840</orcidid></search><sort><creationdate>20220901</creationdate><title>Impact of preoperative body mass index and weight loss on morbidity and mortality following colorectal cancer—a retrospective cohort study</title><author>Axt, Steffen ; Wilhelm, Peter ; Spahlinger, Ricarda ; Rolinger, Jens ; Johannink, Jonas ; Axt, Lena ; Kirschniak, Andreas ; Falch, Claudius</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c471t-9b5b7a157c8a5364a0f23c1f6e19608053218507f6f4ba86cade88a744ebacc23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Analysis</topic><topic>Anastomotic Leak</topic><topic>Body Mass Index</topic><topic>Body weight</topic><topic>Body weight loss</topic><topic>Cancer</topic><topic>Cancer surgery</topic><topic>Cohort analysis</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Complications</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Information management</topic><topic>Internal Medicine</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Obesity - complications</topic><topic>Oncology, Experimental</topic><topic>Overweight</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Postoperative</topic><topic>Proctology</topic><topic>Prospective Studies</topic><topic>Rectal Neoplasms - surgery</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>Surgery</topic><topic>Weight Loss</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Axt, Steffen</creatorcontrib><creatorcontrib>Wilhelm, Peter</creatorcontrib><creatorcontrib>Spahlinger, Ricarda</creatorcontrib><creatorcontrib>Rolinger, Jens</creatorcontrib><creatorcontrib>Johannink, Jonas</creatorcontrib><creatorcontrib>Axt, Lena</creatorcontrib><creatorcontrib>Kirschniak, Andreas</creatorcontrib><creatorcontrib>Falch, Claudius</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Axt, Steffen</au><au>Wilhelm, Peter</au><au>Spahlinger, Ricarda</au><au>Rolinger, Jens</au><au>Johannink, Jonas</au><au>Axt, Lena</au><au>Kirschniak, Andreas</au><au>Falch, Claudius</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of preoperative body mass index and weight loss on morbidity and mortality following colorectal cancer—a retrospective cohort study</atitle><jtitle>International journal of colorectal disease</jtitle><stitle>Int J Colorectal Dis</stitle><addtitle>Int J Colorectal Dis</addtitle><date>2022-09-01</date><risdate>2022</risdate><volume>37</volume><issue>9</issue><spage>1983</spage><epage>1995</epage><pages>1983-1995</pages><issn>1432-1262</issn><issn>0179-1958</issn><eissn>1432-1262</eissn><abstract>Purpose
Body weight and preoperative weight loss (WL) are controversially discussed as risk factors for postoperative morbidity and mortality in colorectal cancer surgery. The objective of this study is to determine whether body mass index (BMI) or WL is associated with a higher postoperative complication rate.
Methods
In this retrospective cohort study, data analysis of 1241 consecutive patients undergoing colorectal cancer surgery in an 11-year period was performed. The main outcome measures were wound infections (WI), anastomotic leakages (AL), and in-house mortality.
Results
A total of 697 (56%) patients with colon and 544 (44%) with rectum carcinoma underwent surgery. The rate of WI for each location increased with rising BMI. The threshold value was 28.8 kg/m
2
. Obese patients developed significantly more WI than normal-weight patients did following rectal resection (18.0% vs. 8.2%,
p
= 0.018). Patients with preoperative WL developed significantly more AL following colon resections than did patients without preoperative WL (6.2% vs. 2.5%,
p
= 0.046). In-house mortality was significantly higher in obese patients following colon resections than in overweight patients (4.3% vs. 0.4%,
p
= 0.012). Regression analysis with reference to postoperative in-house mortality revealed neither increased BMI nor WL as an independent risk factor.
Conclusions
Increased preoperative BMI is associated with a higher WI rate. AL rate after colon resection was significantly higher in patients showing preoperative WL. Preoperative BMI and WL are therefore risk factors for postoperative morbidity in this study. Nevertheless, this has to be further clarified by means of prospective studies.
Trial registration
DRKS00025359, 21.05.2021, retrospectively registered.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>35948668</pmid><doi>10.1007/s00384-022-04228-1</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0002-6809-2840</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1432-1262 |
| ispartof | International journal of colorectal disease, 2022-09, Vol.37 (9), p.1983-1995 |
| issn | 1432-1262 0179-1958 1432-1262 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_9436834 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Analysis Anastomotic Leak Body Mass Index Body weight Body weight loss Cancer Cancer surgery Cohort analysis Colorectal cancer Colorectal carcinoma Complications Gastroenterology Hepatology Humans Information management Internal Medicine Medicine Medicine & Public Health Morbidity Mortality Obesity - complications Oncology, Experimental Overweight Patient outcomes Patients Postoperative Proctology Prospective Studies Rectal Neoplasms - surgery Retrospective Studies Risk factors Surgery Weight Loss |
| title | Impact of preoperative body mass index and weight loss on morbidity and mortality following colorectal cancer—a retrospective cohort study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-20T17%3A15%3A27IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Impact%20of%20preoperative%20body%20mass%20index%20and%20weight%20loss%20on%20morbidity%20and%20mortality%20following%20colorectal%20cancer%E2%80%94a%20retrospective%20cohort%20study&rft.jtitle=International%20journal%20of%20colorectal%20disease&rft.au=Axt,%20Steffen&rft.date=2022-09-01&rft.volume=37&rft.issue=9&rft.spage=1983&rft.epage=1995&rft.pages=1983-1995&rft.issn=1432-1262&rft.eissn=1432-1262&rft_id=info:doi/10.1007/s00384-022-04228-1&rft_dat=%3Cgale_pubme%3EA715923373%3C/gale_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2709044841&rft_id=info:pmid/35948668&rft_galeid=A715923373&rfr_iscdi=true |