Postoperative complications in obese and nonobese patients
Postoperative complications in obese and nonobese patients
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DOI：
10.1007/s00268-006-0305-0
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发表时间：
2007-03-01
影响因子：
2.6
通讯作者：
Dorje, Pema
中科院分区：
文献类型：
--
作者：
Bamgbade, Olumuyiwa A.;Rutter, Timothy W.;Dorje, Pema
背景：手术后并发症是不希望的，在日益增加的肥胖手术患者中可能很常见。最近缺乏比较肥胖和非肥胖患者术后发病率和死亡率的可靠研究。本研究的目的是评估肥胖和非肥胖手术patients.Methods的患病率，模式和术后并发症的严重程度：回顾性分析和成人术后并发症的电子数据库记录进行。该数据库涵盖了4年的时间，包括7，271例在非心脏中度或重大手术后30天内发生的术后并发症。结果：术后并发症发生率为7.7%。肥胖患者心肌梗死（P = 0.001）、周围神经损伤（P = 0.039）、伤口感染（P = 0.001）和尿路感染（P = 0.004）的患病率较高。).病态肥胖患者的死亡率为2.2%，高于所有其他患者的1.2%（P = 0.034），气管再插管（P = 0.009）和心脏骤停（P = 0.015）的发生率更高。肥胖患者的美国麻醉医师协会（阿萨）的身体状况评分高于其他患者（P = 0.001）。结论：肥胖患者术后心肌梗死、伤口感染、神经损伤和泌尿系感染的风险明显较高。肥胖是围手术期发病的独立危险因素，病态肥胖是死亡的危险因素。
Background: Postoperative complications are undesirable and potentially common in the increasing obese population of surgical patients. There is a scarcity of recent and reliable studies comparing postoperative morbidity and mortality in obese and nonobese patients. The aim of this study was to evaluate the prevalence, pattern, and severity of postoperative complications in obese and nonobese surgical patients.Methods: A retrospective review and analysis of adult postoperative complications recorded on an electronic database was conducted. The database covered a period of 4 years and consisted of 7,271 cases of postoperative complications that occurred within 30 days of noncardiac moderate or major surgery. Appropriate data and variables were compared between obese and nonobese patients using the SPSS program.Results: The rate of postoperative complications was 7.7%. Obese patients had a higher prevalence of myocardial infarction (P = 0.001), peripheral nerve injury (P = 0.039), wound infection (P = 0.001), and urinary tract infection (P = 0.004). ). Morbidly obese patients had a higher mortality rate of 2.2% compared with 1.2%; for all other patients (P = 0.034) and a higher prevalence of tracheal reintubation (P = 0.009) and cardiac arrest (P = 0.015). Obese patients had higher American Society of Anesthesiologists (ASA) physical status scores than other patients (P = 0.001).Conclusions: Obese patients have a significantly higher risk of postoperative myocardial infarction, wound infection, nerve injury, and urinary infection. Obesity is an independent risk factor for perioperative morbidity, and morbid obesity is a risk factor for mortality.