Simple measurement of intra-abdominal fat for abdominal surgery outcome prediction Journal Article
| Authors: | Morris, K.; Tuorto, S.; Gonen, M.; Schwartz, L.; DeMatteo, R.; D'Angelica, M.; Jarnagin, W. R.; Fong, Y. |
| Article Title: | Simple measurement of intra-abdominal fat for abdominal surgery outcome prediction |
| Abstract: | Objective: To assess the effect of increasing body mass index, intra-abdominal fat, and outer abdominal fat on outcome in patients undergoing major hepatectomy. Design: Cohort study. Setting: Memorial Sloan-Kettering Cancer Center. Participants: We studied patients aged 19 to 86 years undergoing major hepatic resection between June 18, 1996, and November 6, 2001. Complications were extracted from a prospective database at a tertiary cancer center. Intervention: A total of 349 patients were grouped according to body mass index for analysis. Preoperative abdominal computed tomographic scans were examined and measurements of perinephric fat (as a surrogate for intra-abdominal fat) and outer abdominal fat taken at uniform anatomical locations. Main Outcome Measures: We compared 30-day mortality and morbidity figures, length of stay, and operating times. Results: Body mass index had an influence on operative time (P=.02) but no significant effect on mortality, frequency of any complications, frequency of severe complications, or length of stay (P=.80, P=.89, P=.16, and P=.81, respectively). Outer abdominal fat had no significant effect on any of the 5 outcome measures. Perinephric fat measurements had a significant effect on most outcome measures (P=.004 for mortality, P=.003 for frequence of complications, P<.001 for frequence of severe complications, and P=.001 for length of stay). Conclusions: Outer appearances of obesity do not correlate with poor outcomes for major upper abdominal operations. A simple measurement of perinephric fat, as a surrogate for intra-abdominal fat, on preoperative imaging gives a more useful risk assessment for patients undergoing major upper abdominal operations. ©2010 American Medical Association. All rights reserved. |
| Keywords: | adult; aged; aged, 80 and over; middle aged; major clinical study; mortality; outcome assessment; prospective studies; computer assisted tomography; logistic models; morbidity; obesity; tomography, x-ray computed; prediction; risk assessment; postoperative complication; postoperative complications; poisson distribution; length of stay; body mass; correlation analysis; body mass index; operation duration; surgical risk; predictive value of tests; liver resection; major surgery; hepatectomy; abdominal surgery; abdominal fat; intraabdominal fat; outer abdominal fat; perinephric fat; intra-abdominal fat |
| Journal Title: | Archives of Surgery |
| Volume: | 145 |
| Issue: | 11 |
| ISSN: | 0004-0010 |
| Publisher: | American Medical Association |
| Date Published: | 2010-11-01 |
| Start Page: | 1069 |
| End Page: | 1073 |
| Language: | English |
| DOI: | 10.1001/archsurg.2010.222 |
| PUBMED: | 21079095 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Export Date: 20 April 2011" - "CODEN: ARSUA" - "Source: Scopus" |
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