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
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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“This classification is a widely adopted and validated system that grades the severity of complications based on the type of therapeutic intervention required.”
From Evaluation of safety of preoperative GLP-1 receptor agonists in patients undergoing elective surgery: a systematic review, meta-analysis and meta-regression (2025) · cites this paper as [20]
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Dindo, D., Demartines, N., & Clavien, P.-A. (2004) · Annals of Surgery · doi:10.1097/01.sla.0000133083.54934.ae · Cited by 31,378
Mullen, J. T., Moorman, D. W., & Davenport, D. L. (2009) · Annals of Surgery · doi:10.1097/sla.0b013e3181ad8935 · Cited by 600
Heber, D., Greenway, F. L., Kaplan, L. M., Livingston, E., Salvador, J., & Still, C. (2010) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2009-2128 · Cited by 521
Obesity and spine surgery: relation to perioperative complications
Patel, N. H., Bagan, B. T., Vadera, S., Maltenfort, M., Deutsch, H., Vaccaro, A. R., Harrop, J. S., Sharan, A. D., & Ratliff, J. K. (2007) · Journal of Neurosurgery Spine · doi:10.3171/spi.2007.6.4.1 · Cited by 448
Mechanick, J. I., Kushner, R. F., Sugerman, H. J., González-Campoy, J. M., Collazo–Clavell, M. L., Guven, S., Spitz, A. F., Apovian, C. M., Livingston, E. H., Brolin, R. E., et al. (2008) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2008.08.009 · Cited by 384
Metadata
- Authors
- Dindo, D., Muller, M. K., Weber, M., & Clavien, P.-A.
- Affiliations
- University Hospital Zurich (CH)
- Corresponding author
- 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
- 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
- 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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