Abdominal Contouring Outcomes in Class III Obesity

Analysis of the ACS-NSQIP Database

Husain T. AlQattan, Leela S. Mundra, Gustavo A. Rubio, Seth Thaller

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Obesity may increase the risk of complications following abdominal contouring. The aim of this study is to evaluate panniculectomy outcomes in patients with class III obesity (BMI > 40 kg/m2). Methods: The American College of Surgeon’s National Surgical Quality Improvement Program ACS-NSQIP (2010–2014) was used to identify patients who underwent panniculectomy. Class III obesity patients were identified. Demographics, comorbidities and postoperative outcomes were evaluated. Risk-adjusted multivariate logistic regression analyses were performed to assess impact of class III obesity on panniculectomy outcomes. Results: A total of 4497 panniculectomies were identified. Of these, 545 (12.1%) were performed in patients with class III obesity. This group was older (mean age 50.3 vs. 45.9, p < 0.01) with a higher proportion of men (23.4 vs. 12.4%, p < 0.01). Class III obesity group also had higher rates of comorbidities (p < 0.01). Postoperatively, class III obesity patients experienced much higher rates of wound complications (17.8 vs. 6.8%), sepsis (3.3 vs. 0.8%), venous thromboembolism (1.5 vs. 0.7%) and medical complications (6.4 vs. 1.8%), p < 0.05. Additionally, this group had higher rates of unplanned reoperation (9.2 vs. 3.7%) and 30-day readmissions (3.5 vs. 1.0%), p < 0.01. On risk-adjusted multivariate regression analyses, class III obesity was independently associated with increased risk of wound complications (OR 2.22, p < 0.01), sepsis (OR 3.53, p < 0.01), medical adverse events (OR 1.98, p < 0.05), unplanned reoperation (OR 1.62, p < 0.05) and 30-day readmission (OR 2.30, p < 0.05). Conclusion: Class III obesity patients are at significantly increased risk of adverse outcomes following abdominal contouring. Plastic surgeons should consider these risks for counseling and preoperative risk optimization. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalAesthetic Plastic Surgery
DOIs
StateAccepted/In press - Oct 12 2017

Fingerprint

Obesity
Databases
Abdominoplasty
Reoperation
Comorbidity
Sepsis
Regression Analysis
Evidence-Based Medicine
Venous Thromboembolism
Wounds and Injuries
Quality Improvement
Counseling
Multivariate Analysis
Logistic Models
Demography

Keywords

  • Aesthetics
  • NSQIP
  • Obesity
  • Panniculectomy
  • Plastic surgery
  • Surgical site infections

ASJC Scopus subject areas

  • Surgery

Cite this

Abdominal Contouring Outcomes in Class III Obesity : Analysis of the ACS-NSQIP Database. / AlQattan, Husain T.; Mundra, Leela S.; Rubio, Gustavo A.; Thaller, Seth.

In: Aesthetic Plastic Surgery, 12.10.2017, p. 1-8.

Research output: Contribution to journalArticle

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abstract = "Background: Obesity may increase the risk of complications following abdominal contouring. The aim of this study is to evaluate panniculectomy outcomes in patients with class III obesity (BMI > 40 kg/m2). Methods: The American College of Surgeon’s National Surgical Quality Improvement Program ACS-NSQIP (2010–2014) was used to identify patients who underwent panniculectomy. Class III obesity patients were identified. Demographics, comorbidities and postoperative outcomes were evaluated. Risk-adjusted multivariate logistic regression analyses were performed to assess impact of class III obesity on panniculectomy outcomes. Results: A total of 4497 panniculectomies were identified. Of these, 545 (12.1{\%}) were performed in patients with class III obesity. This group was older (mean age 50.3 vs. 45.9, p < 0.01) with a higher proportion of men (23.4 vs. 12.4{\%}, p < 0.01). Class III obesity group also had higher rates of comorbidities (p < 0.01). Postoperatively, class III obesity patients experienced much higher rates of wound complications (17.8 vs. 6.8{\%}), sepsis (3.3 vs. 0.8{\%}), venous thromboembolism (1.5 vs. 0.7{\%}) and medical complications (6.4 vs. 1.8{\%}), p < 0.05. Additionally, this group had higher rates of unplanned reoperation (9.2 vs. 3.7{\%}) and 30-day readmissions (3.5 vs. 1.0{\%}), p < 0.01. On risk-adjusted multivariate regression analyses, class III obesity was independently associated with increased risk of wound complications (OR 2.22, p < 0.01), sepsis (OR 3.53, p < 0.01), medical adverse events (OR 1.98, p < 0.05), unplanned reoperation (OR 1.62, p < 0.05) and 30-day readmission (OR 2.30, p < 0.05). Conclusion: Class III obesity patients are at significantly increased risk of adverse outcomes following abdominal contouring. Plastic surgeons should consider these risks for counseling and preoperative risk optimization. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.",
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AU - Thaller, Seth

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N2 - Background: Obesity may increase the risk of complications following abdominal contouring. The aim of this study is to evaluate panniculectomy outcomes in patients with class III obesity (BMI > 40 kg/m2). Methods: The American College of Surgeon’s National Surgical Quality Improvement Program ACS-NSQIP (2010–2014) was used to identify patients who underwent panniculectomy. Class III obesity patients were identified. Demographics, comorbidities and postoperative outcomes were evaluated. Risk-adjusted multivariate logistic regression analyses were performed to assess impact of class III obesity on panniculectomy outcomes. Results: A total of 4497 panniculectomies were identified. Of these, 545 (12.1%) were performed in patients with class III obesity. This group was older (mean age 50.3 vs. 45.9, p < 0.01) with a higher proportion of men (23.4 vs. 12.4%, p < 0.01). Class III obesity group also had higher rates of comorbidities (p < 0.01). Postoperatively, class III obesity patients experienced much higher rates of wound complications (17.8 vs. 6.8%), sepsis (3.3 vs. 0.8%), venous thromboembolism (1.5 vs. 0.7%) and medical complications (6.4 vs. 1.8%), p < 0.05. Additionally, this group had higher rates of unplanned reoperation (9.2 vs. 3.7%) and 30-day readmissions (3.5 vs. 1.0%), p < 0.01. On risk-adjusted multivariate regression analyses, class III obesity was independently associated with increased risk of wound complications (OR 2.22, p < 0.01), sepsis (OR 3.53, p < 0.01), medical adverse events (OR 1.98, p < 0.05), unplanned reoperation (OR 1.62, p < 0.05) and 30-day readmission (OR 2.30, p < 0.05). Conclusion: Class III obesity patients are at significantly increased risk of adverse outcomes following abdominal contouring. Plastic surgeons should consider these risks for counseling and preoperative risk optimization. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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