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

The DOI matches its Crossref record; 32 of the 32 references it cites were found in a registry or an index.

Obesity in general elective surgery

Dindo, Daniel, Muller, Markus K, Weber, Markus, Clavien, Pierre-Alain·2003·The Lancet
DOI 10.1016/s0140-6736(03)13640-9
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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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Crossref · 10.1016/s0140-6736(03)13640-9

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Metadata

Authors
Dindo, D., Muller, M. K., Weber, M., & Clavien, P.-A.
Affiliations
University Hospital Zurich (CH)
Corresponding author
Clavien, Pierre-Alain
ORCID
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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