Simple measurement of intra-abdominal fat for abdominal surgery outcome prediction. Academic Article uri icon

start page

  • 1069

end page

  • 1073

abstract

  • To assess the effect of increasing body mass index, intra-abdominal fat, and outer abdominal fat on outcome in patients undergoing major hepatectomy.Cohort study.Memorial Sloan-Kettering Cancer Center.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.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.We compared 30-day mortality and morbidity figures, length of stay, and operating times.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).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.

date/time value

  • November 2010

Digital Object Identifier (DOI)

  • 10.1001/archsurg.2010.222

PubMed Identifier

  • 21079095

volume

  • 145

number

  • 11

keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Female
  • Hepatectomy
  • Humans
  • Intra-Abdominal Fat
  • Length of Stay
  • Logistic Models
  • Male
  • Middle Aged
  • Poisson Distribution
  • Postoperative Complications
  • Predictive Value of Tests
  • Prospective Studies
  • Risk Assessment
  • Tomography, X-Ray Computed