School of Medicine and Health Sciences Poster Presentations
Poster Number
293
Document Type
Poster
Status
Medical Student
Abstract Category
Obesity
Keywords
hysterectomy, obesity, BMI, postoperative, complications
Publication Date
Spring 2018
Abstract
Background: The prevalence of obesity in American women is 38.3%. Hysterectomy is the second most common surgery in reproductive age women; most of these procedures are performed laparoscopically. From 2011 to 2015, 3.2% of women age 15-44 years underwent hysterectomy; 89.6% of these procedures were performed for management of medical conditions including uterine fibroids, menstrual disorders, uterine prolapse, and endometriosis. The high rates of obesity and hysterectomy in women demand better understanding of the relationship between obesity and postoperative complications following laparoscopic hysterectomy. Methods: We conducted a retrospective cohort study using the American College of Surgeons National Quality Improvement Database (ACS-NSQIP) by identifying all patients who underwent laparoscopic total hysterectomy, laparoscopic assisted vaginal hysterectomy, or laparoscopic supracervical hysterectomy from 2007 to 2013 using Current Procedural Terminology (CPT) codes. These patients were stratified by BMI (40); univariate and multivariate analyses were then performed to evaluate the incidence of postoperative complications in these groups. Results: Patients with BMI > 30 were more likely to experience postoperative complications including superficial surgical site wound infection, deep surgical site infection, failure to wean from the ventilator > 48 hours, unplanned reintubation, deep vein thrombosis, pulmonary embolism, urinary tract infection, renal insufficiency, renal failure, and extended hospital length of stay > 2 days. Multivariate analysis suggests that BMI > 30 is an independent risk factor for superficial surgical site infection, deep vein thrombosis, and pulmonary embolism. Conclusion: Patients with obesity and morbid obesity were more likely to present with risk factors and comorbidities than nonobese patients. While complication rates following laparoscopic hysterectomy are low across BMI groups, patients with BMI > 30 were more likely to suffer from at least one postoperative complication. Data indicate that obesity may contribute to a significantly increased risk of deep vein thrombosis and pulmonary embolism in the postoperative period, suggesting the need for additional venous thromboembolism prophylaxis. Obesity should be considered when planning for and performing laparoscopic hysterectomy.
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Open Access
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Included in
Morbid obesity is associated with postoperative complications in laparoscopic hysterectomy
Background: The prevalence of obesity in American women is 38.3%. Hysterectomy is the second most common surgery in reproductive age women; most of these procedures are performed laparoscopically. From 2011 to 2015, 3.2% of women age 15-44 years underwent hysterectomy; 89.6% of these procedures were performed for management of medical conditions including uterine fibroids, menstrual disorders, uterine prolapse, and endometriosis. The high rates of obesity and hysterectomy in women demand better understanding of the relationship between obesity and postoperative complications following laparoscopic hysterectomy. Methods: We conducted a retrospective cohort study using the American College of Surgeons National Quality Improvement Database (ACS-NSQIP) by identifying all patients who underwent laparoscopic total hysterectomy, laparoscopic assisted vaginal hysterectomy, or laparoscopic supracervical hysterectomy from 2007 to 2013 using Current Procedural Terminology (CPT) codes. These patients were stratified by BMI (40); univariate and multivariate analyses were then performed to evaluate the incidence of postoperative complications in these groups. Results: Patients with BMI > 30 were more likely to experience postoperative complications including superficial surgical site wound infection, deep surgical site infection, failure to wean from the ventilator > 48 hours, unplanned reintubation, deep vein thrombosis, pulmonary embolism, urinary tract infection, renal insufficiency, renal failure, and extended hospital length of stay > 2 days. Multivariate analysis suggests that BMI > 30 is an independent risk factor for superficial surgical site infection, deep vein thrombosis, and pulmonary embolism. Conclusion: Patients with obesity and morbid obesity were more likely to present with risk factors and comorbidities than nonobese patients. While complication rates following laparoscopic hysterectomy are low across BMI groups, patients with BMI > 30 were more likely to suffer from at least one postoperative complication. Data indicate that obesity may contribute to a significantly increased risk of deep vein thrombosis and pulmonary embolism in the postoperative period, suggesting the need for additional venous thromboembolism prophylaxis. Obesity should be considered when planning for and performing laparoscopic hysterectomy.
Comments
Presented at GW Annual Research Days 2018.