Cited by 631Cardiac, Anesthesia and Surgical OutcomesObesity, Physical Activity, DietBariatric Surgery and Outcomes

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Obesity in general elective surgery

Dindo, Daniel, Muller, Markus K, Weber, Markus, Clavien, Pierre-Alain·2003·The Lancet

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Abstract

Background Obese patients are generally believed to be at a higher risk for surgery than those who are not obese, although convincing data are lacking.Methods We prospectively investigated a cohort of 6336 patients undergoing general elective surgery at our institution to assess whether obesity affects the outcome of surgery. Exclusion criteria were emergency, vascular, thoracic, and bariatric operations; transplantation procedures; patients under immunosuppression; and operations done under local anaesthesia. Postoperative morbidity was analysed for non-obese and obese patients (body-mass index <30 kg/m(2) vs >or=30 kg/m(2)). Obesity was further stratified into mild obesity (30.0-34.9 kg/m(2)) and severe obesity (>or=35 kg/m(2)). Risk factors were analysed with univariate and multivariate models.Findings The cohort consisted of 6336 patients, of whom 808 (13%) were obese, 569 (9%) were mildly obese, and 239 (4%) had severe obesity. The morbidity rates in patients who were obese compared with those who were not were much the same (122 [15.1%] of 808 vs 901 [16.3%] of 5528; p=0.26), with the exception of an increased incidence of wound infections after open surgery in patients who were obese (17 [4%] of 431 vs 92 [3%] of 3555, p=0.03). Incidence of complications did not differ between patients who were mildly obese (91 [16.0%] of 569), severely obese (36 [15.1%] of 239), and non-obese (901 [16.3%] of 5528; p=0.19). In multivariate regression analyses, obesity was not a risk factor for development of postoperative complications. Of note, the additional medical resource use as estimated by a new classification of complications showed no differences between patients who were and were not obese.Interpretation Obesity alone is not a risk factor for postoperative complications. The regressive attitude towards general surgery in obese patients is no longer justified.

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Authors: Dindo, D., Muller, M. K., Weber, M., & Clavien, P.-A.
Affiliations: University Hospital Zurich (CH)
Corresponding author: Clavien, Pierre-Alain
ORCID: Weber, Markus
Clavien, Pierre-Alain
Venue: The Lancet
Publisher: Elsevier BV
Published: 2003-06
Volume: 361
Issue: 9374
Pages: 2032-2035
ISSN: 0099-5355 (ISSN-L)
0140-6736
DOI: 10.1016/s0140-6736(03)13640-9
OpenAlex: W2135384303
Cited by: 630
References: 32
Citations by year: 2026: 3 · 2025: 19 · 2024: 16 · 2023: 20 · 2022: 22 · 2021: 23 · 2020: 26 · 2019: 31 · 2018: 16 · 2017: 25 · 2016: 49 · 2015: 33 · 2014: 32 · 2013: 45 · 2012: 39
FWCI: 12.56
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Lancet (publishedVersion)
PubMed (publishedVersion)
Funders: Universität Zürich
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac, Anesthesia and Surgical Outcomes
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
Keywords: obesity, postoperative complications, postoperative morbidity, body mass index, wound infection, surgical risk factors, medical resource use, morbid obesity
MeSH terms: Adult, Analysis of Variance, Female, Humans, Length of Stay, Male, Middle Aged, Obesity, Postoperative Complications, Prospective Studies, Risk Factors, Surgical Wound Infection, Elective Surgical Procedures

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